95 00153
Continuum of Care
San Francisco
A Five Year Strategic Homeless Plan
Mayor's Homeless Budget Advisory
Task Force
First Draft
Mayor Frank M. Jordan
October 1994
TABLE OF CONTENTS .
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Summary of Polaris Report on Service Gaps
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Description of the Continuum of Care
Prevention Plan
Emergency Services Plan
Transitional Housing and Services Plan
Permanent Housing Plan
Follow-up and Support Services Plan
Employment and Training Plan
Civil Rights Plan
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Continuum of Care Plan - Draft Pagel October 18, 1994
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CONTINUUM OF CARE SAN FRANCISCO
“EXECUTIVE SUMMARY
The Continuum of Care is a comprehensive five year plan for assisting
individuals and families who are homeless or at risk of homelessness.
The Major Goals of the Plan are to:
1. Provide a coordinated and integrated system of health care, housing,
employment, and support services and resources to prevent and reduce
homelessness among individuals and families in San Francisco.
2. Establish a mechanism to ensure that the Continuum of Care Plan governs
and guides all homeless policy and budget decisions in San Francisco.
Problems of Current Approaches to Addressing Homelessness
Homelessness is a major problem facing our city. Despite the significant
investment of fiscal and human resources the problem persists. Even with the
extraordinary dedication of non-profit agencies, volunteer groups, and civic
leaders we have been unable to make substantial progress toward solving the
problem. We have not significantly reduced the number of individuals and
families on our streets, nor the number of people who recycle month after month
through our shelters without other alternatives.
Current approaches to addressing homelessness in San Francisco are not
effective for several reasons:
¢ Our major focus in addressing homelessness has been on short-term strategies
such as the provision of emergency shelter and hotels. Over one-half (57%) of
FY 93-94 homeless expenditures are for emergency services.
¢ Homelessness is not a temporary or short-term problem. Homelessness is the
result of a complex set of economic, social and personal factors which require
long-term solutions. Shelter services address symptoms and not causes. Shelters
cannot substitute for the stability of permanent housing nor the security of
earned income.
¢ Lack of integrated treatment services for homeless people with substance
abuse and/or mental health problems is a major barrier and must be addressed
if we are to permanently exit people out of homlessness.
¢ Services for homeless individuals and families have not been provided
through a coordinated and centralized system and current practices do not work
Continuum of Care Plan - Draft Page 3 October 18, 1994
for the benefit of the individuals and families served.
¢ As a city we have not had in place a cohesive long-range plan for preventing
people from becoming homeless nor for providing the permanent housing,
treatment, and employment services to successfully exit people out of
homelessness. |
Development of the Continuum of Care Plan
The development of this document was set in motion by two events:
1. In January 1994, Mayor Frank Jordan established the Mayor’s Homeless
Budget Advisory Task Force for the purpose of assessing homeless
expenditures in San Francisco and for developing a long-range plan on
homelessness. The Task Force is a 35 member body which includes the
Board of Supervisors, all relevant City Departments, formerly homeless
people, service provider and advocacy groups, representatives of the
foundation and corporate sector, and business and community
organizations.
2. In April 1994, HUD announced an initiative to consolidate several homeless
funding sources into block grants to cities and counties. The intent of the
consolidation is to give local govenment more control over HUD homeless
funding and more flexibility for long range planning. HUD is requiring that
local jurisdictions develop long range strategic plans for addressing
homelessness in their communities.
These two events resulted in a broad-based homeless planning effort.
Members of the Task Force met with each member of the Board of
Supervisors. Twelve focus groups and numerous presentations and
discussions were held with service providers, homeless and formerly
homeless people, city departments, and representatives from foundations,
business and community groups. Nearly 300 people participated in this
initial planning phase.
Fiscal Findings
The fiscal assessment of homeless expenditures was conducted by the Mayor’s
Fiscal Advisory Committee (MFAC) and Polaris Research and Development
(Polaris). The results of the fiscal analysis conducted by MFAC and Polaris are
the following:
1. For FY 1993-94, a total of $79.9 million was incurred for homeless services
in San Francisco representing $56.1 million which flowed though City
departments from General Fund, federal, state and private sources, and
$23.8 million spent in non-profit agencies. The $23.8 million in non-profit
Continuum of Care Plan - Draft Page 4 October 18, 1994
agencies represents non-City funds (federal, state and private) that flow
directly to non-profits.
2. Of the $56 million that flowed through City departments, $38.8 million
(69%) came from the City’s General Fund, $14.6 million (26%) came from
federal sources, and $2.4 million (4%) came from state sources.
3. Of the $23.8 million expended by non-profits, $20 million came from the
private sector, $3 million came from federal sources and $800,000 came
from state sources.
4. Of the total $79.9 million spent, $46.2 million (58%) was for core
expenditures (services specifically designated for homeless people), and
$33.7 million (42%) was for ancillary services (services for low-income
persons but also used by homeless persons).
5. In addition to the $79.9 million spent for homeless services, there was $16.2
million incurred for acquisition and construction of low-income housing for
homeless persons.
6. Over one-half of the homeless funds expended (63%) are for emergency
services including shelter services. Significantly less money is expended on
prevention (1% of funds) or on services connected to permanent housing
(6.6% of funds).
7. Expenditures among the 47 non-profit agencies generally parallels
expenditures in City funding with the greatest funding allocated for
emergency services including emergency shelter and hotels.
What is the Continuum of Care?
The Continuum of Care is an integrated and coordinated system of housing,
health care and support services to prevent and reduce homelessness. The
continuum is designed to move homeless people as quickly as possible to the
greater levels of responsibility and independence that permanent housing,
training and employment would provide. The continuum consists of five
components:
Prevention: To address housing and service needs before they emerge in crisis
form. Prevention strategies include family support centers, eviction prevention
programs, preventative health care, and substance abuse relapse services.
Emergency Services: To provide immediate, accessible and integrated health,
shelter, and support services to address emergency situations and provide access
to the next level of treatment, housing and support that is necessary.
Continuum of Care Plan - Draft Page5 October 18, 1994
Transitional Housing and Services: To provide a transition for individuals and
families who have substance abuse, mental health or other personal problems
which need to be addressed before they can move to permanent housing.
Permanent Housing: To provide housing connected to support services so that
individuals and families can maintain residential, economic and personal
stability and develop the support networks that ensure self-sufficiency.
Follow-Up and Support Services: To ensure that each person has the
opportunity to access the housing, treatment, employment and support services
to maintain personal and/or family stability, and to monitor the success of the
system and the individual in reaching these goals.
A number of essential services will cut across all five continuum components.
These include substance abuse and mental health treatment, employment
services and follow-up and support services. Integrated primary health care and
substance abuse and mental health treatment will be a necessity for homeless
people with multiple disabilities. Employment services, including job creation,
on-the-job training and job placement will be critical to building skills and
economic independence.
Recommendations Of the Continuum of Care Plan
The major recommendations of the Continuum of Care Plan include the
following:
1. A five year housing production plan to provide housing and support
services to very low-income people.
2. Integrated and expanded substance abuse, mental health and primary
health care services.
3. Centralization and computerization of information to provide more
immediate, accessible, and effective service delivery.
4. Prevention programs such as family support centers to provide early
intervention to reduce homelessness among families with children.
5. Employment strategies to create new jobs, and more effectively use
mainstream training programs to increase skill development, job training
and job placement.
6. Improved coordination between City departments to eliminate barriers to
efficient service delivery and to ensure accountability and monitoring of the
Plan.
Continuum of Care Plan - Draft Page 6 October 18, 1994
Management of the Continuum of Care Plan
A major goal of the Plan is to ensure that the Continuum of Care is endorsed by
the Mayor and the Board of Supervisors as the official Homeless Plan for the
City and County of San Francisco. The Continuum of Care must be the long-
range strategy which governs and guides all homeless policy and budget
decisions in San Francisco. This authority is essential to executing the
recommendations of the Plan. The Plan requires the establishment of a local
board to govern homeless policy and budget and to promote coordination
among City departments, contract agencies and community groups.
Public Review
The first draft of the Continuum of Care Plan will be broadly distributed for
public review and comment. Members of the Task Force will meet with
members of the Board of Supervisors, heads of City Departments, homeless
people, service providers, as well as neighborhood associations, business
groups, foundations, corporations and community groups. The San Francisco
Coalition on Homelessness and the San Francisco Council on Homelessness will
work with the Task Force on this outreach effort.
The second draft of the Continuum of Care will be completed in January 1995
and will include priorities for funding, costs associated with recommendations,
sources of funding, and identification of responsibility for carrying out
recommendations.
Continuum of Care Plan - Draft Page7 October 18, 1994
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CONTINUUM OF CARE PLAN
GUIDING PRINCIPLES
Principle One
Unified Strategy
San Francisco will have one unified city-wide plan to reduce homelessness
which is supported by the Mayor, the Board of Supervisors, City departments,
housing and service providers, homeless and formerly homeless people,
advocates, and business and neighborhood groups.
Principle Two
Integrated and Coordinated System
Services will be delivered through a coordinated system which incorporates
mainstream services to avoid further expansion of a system exclusively for
homeless people.
Principle Three
Long-term Solutions
While emergency shelter is often a necessary first step in assisting homeless
people, emphasis will be on strategies with the best long-term solutions such as
housing, employment training and treatment services.
Principle Four
Prevention
Prevention is key to addressing homelessness and strategies that maintain
and encourage residential stability, link housing and support services, and
strengthen services in neighborhoods will be encouraged.
Principle Five
Mutual Rights and Responsibilities
Respect for the mutual rights and responsibilities of participants, providers and
funders of homeless services, and the public at large, is essential to the success of
the continuum of care strategy.
Continuum of Care Plan - Draft Page 9 October 18, 1994
Principle Six
Participation of Consumers
Homeless and formerly homeless people, and those at risk of homelessness, will
participate in the planning, development, and evaluation of programs and
services.
Principle Seven
Accessible Services
Services and information will be easily accessible to participants of the
system as well as the public at large.
Principle Eight
Fair Share Distribution
_A fair share policy will be instituted to ensure affordable housing and
supportive services throughout the city.
Principle Nine
Equal Access
Equal access to the system will be provided regardless of mental or physical
disability, complexity of need, language or cultural difference.
Principle Ten
Meeting the Need
Services and resources to reduce homelessness will be provided in proportion to
the need through expansion of services, redirecting of existing funds, leveraging
new funds and refocusing programs and services.
Continuum of Care Plan - Draft Page 10 October 18,1994
INTRODUCTION
This document is a proposal for establishing a comprehensive five year plan -- a
Continuum of Care - for assisting individuals and families who are homeless or
at risk of homelessness.
The plan is based on the wisdom and experience of the people who use homeless
services, the staff of agencies who provide the services, the public and private
agencies who fund the services, and members of the community who have given
of their time and expertise.
Homelessness is one of the most pressing and intractable problems facing our
city. We are frustrated and perplexed that the problem persists despite the
investment of considerable fiscal and human resources. Even with the
extraordinary efforts of non-profit agencies in serving homeless people and the
support and dedication of civic leaders and community volunteers, we have
been unable to make substantial progress toward solving the problem. We have
not significantly reduced the number of homeless people on our streets nor the
number of people who recycle month after month through our shelters. As an
example, a recent Department of Social Services (DSS) survey reported that 44%
of the homeless families who stayed in our shelters during 1993-94 had had a
prior shelter stay.
The Continuum of Care Plan recommends the actions that must be taken to
build an effective, coordinated and efficient system of services and resources for
reducing homelessness in San Francisco. The Plan recommends long-term
strategies such as prevention, permanent housing, substance abuse and mental
health treatment, and training and employment, which are more cost-effective
than existing short-term approaches and will result in better outcomes for the
individuals and families served.
We are not without our successes and we have much to be proud of. Supportive
housing programs built and managed by formerly homeless people, as well as
transitional programs for families with children, and supported living
environments for mentally disabled people, are but a few examples of effective
programs where individual success stories are plentiful. As a city however, we
have not had in place a cohesive plan for preventing people from becoming
homeless nor for reducing the number of men, women and children who recycle
through our programs and services without other alternatives.
Homelessness in San Francisco
When homelessness became visible in San Francisco in the early 1980s the city
responded as it would to any emergency situation. Churches and synagogues
opened their doors to provide emergency shelter, food lines expanded capacity,
Continuum of Care Plan - Draft Page 11 October 18, 1994
and new agencies were born to meet the growing crisis. By the early 1990s, non-
profit agencies in San Francisco were providing shelter and services to
thousands of homeless individuals and families annually.
With compassion and the best intentions, San Francisco, as well as other major
cities around the country, approached homelessness as a temporary problem to
be solved with temporary measures. We assumed that emergency shelters
would solve the problem and that short-term solutions would suffice.
Our assumptions were wrong. We learned that emergency shelters are a
valuable resource during a short-term crisis, but that they can only provide
short-term solutions. Shelter services address symptoms and not causes, and as
institutions they cannot substitute for the stability of permanent housing nor the
security and reward of earned income.
A fiscal analysis of 1993-94 city-wide homeless expenditures, detailed in a later
section, indicates that the single greatest expenditure from both the public and
non-profit sector is for the provision of emergency services including shelters
and hotels. This plan calls for more cost-effective alternatives with better long-
term benefits to individuals and families. As an example, the costs at one
program of providing shelter for a family of three for one month is $4,500. The
average monthly cost for providing one-time rental assistance for that same
family to prevent homelessness is $650.
The Continuum Of Care Plan shifts the focus from entrances toward permanent
exits and from short term to long-term strategies such as supportive housing,
substance abuse and mental health treatment, employment training to help
people compete in the job market, and prevention to keep individuals and
families from falling over the edge. The Continuum of Care builds on previous
strategic planning efforts in San Francisco including The Twelve Point Homeless
Plan (1988) and Beyond Shelter, which was adopted by the City in 1989 shortly
before the Loma Prieta earthquake.
Goals of the Plan
The major goals of the Plan are:
1. To provide a coordinated and integrated system of health care, housing
employment and support services and resources to prevent and reduce
homelessness in San Francisco.
2. To establish a mechanism to ensure that the Continuum of Care Plan
governs and guides all homeless policy and budget decisions in
San Francisco.
Continuum of Care Plan - Draft Page 12 October 18, 1994
The Plan includes the following recommendations:
1. A five year permanent housing production plan.
2. Integrated and expanded substance abuse, mental health and medical
services.
3. Centralization and computerization of housing, health care and support
service information to provide more coordinated and effective service
delivery.
4, Prevention programs such as family support centers to provide early
intervention to reduce homelessness among families with children.
5. Employment strategies to create new jobs, and more effectively use
mainstream programs to increase skill development, job training and job
placement.
6. Improved coordination between city departments to eliminate barriers to
efficient service delivery and to ensure accountability and evaluation of
outcomes. ?
7. A Management Plan for ensuring that the Continuum of Care Plan governs
and guides all homeless budget and policy in San Francisco.
To help meet our goals are the more than forty non-profit agencies that provide
most of the housing and support services to homeless individuals and families in
San Francisco. The most innovative and cost-effective programs in the City have
been initiated by these agencies. These agencies will play a major role in the
Continuum of Care and will work in partnership with government agencies,
mainstream service providers, volunteer groups, and the private sector to
provide the services necessary to reduce homelessness.
The Need
This plan does not attempt to provide updated counts of the number of
homeless people in San Francisco. While estimates of these numbers vary
depending on methodology, we do know that the number of people on the street
on any given night is less than the number of people experiencing an episode of
homelessness during the year. Estimates are difficult to determine because of
the episodic and transient nature of the lives of many homeless people.
Beyond Shelter in 1989 estimated that there were 6,000-8,000 homeless people in
San Francisco.’The 1990 US Census Bureau figures, based on one night’counts
Continuum of Care Plan - Draft Page 13 October 18, 1994
only, estimated 5,552 homeless persons in San Francisco. The 1990 Residence
Element estimated that there were 6,600 to 7,700 homeless persons in San
Francisco. .
Based on the number of requests for homeless assistance for 1992-93, as well as
general indicators of economic distress, the 1994 Comprehensive Housing
Affordability Strategy (CHAS) concludes that the number of homeless people in
San Francisco has probably not significantly decreased and may have increased
since the 1989 estimates and 1990 counts.
There are currently 1,399 emergency shelter beds (including voucher hotels)
available year round in San Francisco, and an additional 100 beds during the
winter months (DSS 1994). There are as well 798 transitional units for homeless
individuals and families. Added to these figures are the 1,200-1,800 estimated
number of people living outdoors, and the undetermined number of homeless
people about to be released from jails, hospitals, and residential programs with
no permanent address to go to. Of the total 1,733 persons in jail in San Francisco
this past year, estimates are that 25% are homeless (Polaris, 1993).
The United Way Homeless Prevention Helpline reports that the number of
people requesting assistance for shelter, housing, food, rental and utility
assistance rose from 2,157 calls in 1989/90 to 4,103 calls in 1992/93. The
Homeless Assistance Program administered by DSS received 1,719 requests for
housing assistance from families during 1992-93. During 1993-94 requests for
assistance increased to 1,923 requests.
Causes of Homelessness
Homelessness became visible on the streets of this country in the early 1980s.
Not since the Great Depression had America seen the likes of men, women and
children camping on the streets, parks and doorways of our cities. The causes of
this tragic episode in American history can be traced to a number of economic,
political and social factors.
One of the most significant was the decline in federal and state support for
housing construction and a simultaneous decrease in federal rental subsidies. In
the 1980s, federal funding for new low-income housing was cut by 80%. In 1980
federal funds provided housing assistance for an additional 264,000 units of
assistance, mainly in the form of public housing and housing subsidies. By 1988
funds were allocated for only 82,000 additional units (Children’s Defense Fund,
1991).
Purchasing power declined during the late 1980s as housing costs soared and
wages declined. Since 1987, median rents in San Francisco rose nearly 90% while
wages, when adjusted for inflation, declined (CHAS, 1994 ). Only 30 % of low
Continuum of Care Plan - Draft Page 14 October 18, 1994
income families could afford median priced two bedroom apartments
(Residence Element, 1990).
The disparity between income and housing costs for poor individuals and
families is a major cause of homelessness. Almost three quarters (75%) of
extremely low income renter households pay more than 30% of their income on
rent while 55% pay more than 50% of their income on rent. For this population
of individuals and families, any loss of income as the result of a change in living
circumstances, or decline in wages or entitlements, is a serious setback.
Individuals and families receiving welfare payments are clearly at risk of
homelessness because grant levels are below annual poverty guidelines and are
extremely low compared to housing costs. HUD 1993-94 Poverty Guidelines
place the poverty level for a family of three at or below an annual income of
$11,890. The annual 1994 AFDC grant for a family of three is $7,116. The
additional $2,400 annually in food stamps adds to a total of $9,516 which is less
than poverty guidelines.
_ Other factors relate to shifts in the economy during the 1980s. The decline of the
manufacturing industry, once a major source of relatively high paying jobs, was
a serious loss particularly for unskilled and semi-skilled workers. These jobs
were replaced with relatively low paying jobs in the hotel, restaurant. and retail
sector. Lack of employment and training opportunities has had a major impact
on low-income populations who do not have the skills to compete in the job
market. The decay of urban housing, and our lack of success in economically
revitalizing poor neighborhoods, further isolates low-income residents from
economic opportunities (Lemann, 1994).
While poverty is the major cause of homelessness, additional factors increase
the likelihood of its occurrence. Substance abuse, single parenthood among poor
women, youth leaving home or foster care with no place to live, psychiatric
disability, a history of incarceration, and domestic violence are additional risk
factors that make it difficult to break the cycle (Priority Home, 1994). Veterans
from 20-34 years old are almost five times more likely to be homeless and
unemployed than non-veterans. (Northern California Community Services
Council, 1994). The results of a recent survey of individuals and families living in
shelters in San Francisco, described in a later section, indicate the prevalence of
these risk factors in the local homeless population (DSS,1994).
Substance abuse is a major barrier to breaking the cycle of homelessness.
Nationally it is estimated that at least one-half of homeless adults has a current
or past drug problem ( Priority Home). Of the single homeless adults living in
shelters in San Francisco, 40% of the men reported a prior or current substance
abuse problem while 61% of the women reported similarly (DSS, 1994). Lack of
Continuum of Care Plan - Draft Page 15 October 18, 1994
housing, health care and support services for low-income mentally disabled
people, particularly women, has long been identified as a primary cause of
homelessness. Almost one half (45%) of the single adult women staying in
shelters in San Francisco identified mental illness as a cause of homelessness
(DSS, 1994).
_ Lack of supportive networks for families facing the multiple crisis of poverty,
single parenthood, and inadequate skills to earn a living wage, is a significant
factor in the incidence of homelessness among families. Women who are victims
of domestic violence become homeless when they have no other alternative but a
shelter to protect themselves and their children. The lasting effect of
homelessness on children’s health, self-esteem and educational progress has
been documented as well. (Stanford, 1991).
Other at-risk populations include individuals in institutional settings, such as
jails, hospitals and treatment facilities, who have no permanent address, and
youth reaching 18 years of age and leaving foster care without a place to live.
Individuals and families, including seniors, living in substandard housing or in
seriously overcrowded conditions are also at risk of homelessness.
Conclusion
The intent of this first draft report is to present the major findings of the 1993-94
fiscal assessment of homeless services, and to outline the initial strategy and
action recommendations for the proposed Continuum of Care. This draft of the
report does not identify responsibility for implementation of specific strategies,
the associated costs of funding new projects, the funding priorities, nor the
sources of funding. These details will be included in the next draft of the plan.
The goals of this plan are major and they will not be realized through system
revision and reorganization alone. As the City develops social and economic
policies pertaining to economic revitalization, managed health care, and base
closures, such efforts should be compatible with the recommendations of the
Continuum of Care Plan. Local government will require the assistance of the
federal and state government, volunteer groups, and the private sector to
accomplish the tasks before us.
The causes of homelessness are complex and the challenge we face is daunting.
The plan cannot improve the regional economy, eradicate the abuse of drugs,
erase poverty and neglect in inner city neighborhoods, or reform the welfare
system. The plan can however guide us toward a more integrated and efficient
system of services and resources which will bring greater independence to the
individuals and families that are served. In the tradition of a city that has shown
leadership inaddressing social and health issues, let us demonstrate our capacity
to meet this challenge and truly provide a comprehensive continuum of care.
Continuum of Care Plan - Draft Page 16 October 18, 1994
DEVELOPMENT OF THE CONTINUUM OF CARE PLAN
Planning for the Continuum of Care was set into motion by two events. First,
was the establishment in January 1994 by Mayor Jordan of the Mayor’s
Homeless Budget Advisory Task Force for the purpose of evaluating city
expenditures on homeless services and to develop a long-range plan on
homelessness. Second, was the announcement by the Department of Housing
and Urban Development (HUD) in April 1994 to consolidate homeless funding
into block grants and require cities and counties to develop long-range strategic
plans for assisting homeless people in their communities.
The Mayor's Task Force is a 35 member advisory body whose membership
includes homeless and formerly homeless people, the Mayor’s Homeless
Coordinator, representatives from the San Francisco Council on Homelessness,
the San Francisco Coalition on Homelessness, the Homeless Service Providers
Network, the Shelter and Housing Directors Association, the Family Shelter
Network, the Homeless Youth Network, the Northern California Grantmakers,
the San Francisco Board of Supervisors, the Chamber of Commerce, the business
and investment community, the Homeless Economic Development Fund of the
Roberts Foundation, the Department of Social Services, the Department of Public
Health, the AIDS Office, the Mayor’s Office of Housing, The Mayor’s Office of
Community Development, the San Francisco Housing Authority, the San
Francisco Planning and Urban Research Association, and the United Way of the
Bay Area.
The HUD consolidation of homeless grants is intended to give cities and
counties more control over federal homeless funding and provide opportunities
for more long-range planning. The Task Force incorporated the new HUD
requirements into its long range planning and the result was a broad-based
homeless planning effort. The Task Force formed the Continuum of Care
Committee (CCC) for the purpose of developing a five year strategic plan.
CCC membership includes members of the Task Force as well as representatives
from the Council of Community Housing Organizations, the Supported Housing
Network, the San Francisco Mental Health Association, the Council of District
Merchants, and Homebase, a regional homeless policy organization.
The Continuum of Care describes an integrated and coordinated system for
providing health care, treatment, housing, employment and support services to
prevent and reduce homelessness. The five components of the Continuum are:
Prevention, Emergency Services, Transitional Housing and Services, Permanent
Housing and Services, and Follow-Up and Support Services. These components
will be described in greater detail in later sections of this report.
Continuum of Care Plan - Draft Page 17 October 18, 1994
To gather information on funding for homeless services, the Mayor's Fiscal
Advisory Committee (MFAC) assessed 1993-94 City department expenditures
for core and ancillary homeless services. At the same time, the Mayor’s Office
contracted with Polaris Research and Development, a nationally recognized
research and evaluation firm, to conduct a fiscal assessment of homeless
revenues and expenditures in the nonprofit community, as well as gaps in
homeless services.
The Northern California Grantmakers (NCG), a consortium of foundations in the
San Francisco Bay Area, funded a position in the Mayor’s Office to work with
the Mayor’s Homeless Coordinator in developing the Continuum of Care Plan.
In addition, the Department of Social Services (DSS) dedicated a staff person to
assist in the planning process.
In order to ensure the greatest possible participation in the strategic planning
process, twelve focus groups were conducted during July, August and
September 1994 with homeless individuals and families, service providers,
community and advocacy groups and funders of homeless services. The focus
groups were population-based and designed to identify the housing and support
service needs of homeless women, men, families, and youth. Each group was
asked to identify the goals of the Continuum of Care for that population, the
strategies to achieve the goals, and five year funding priorities.
In addition to the focus groups, members of the Task Force met with each
member of the Board of Supervisors, and participated in numerous
presentations and discussions with service provider organizations, employment
and economic development networks, housing developers, health care
providers, and the managers and residents of shelters serving women, families,
and victims of domestic violence. Nearly 300 people participated in the various
focus groups and presentations.
Following the compilation of information from the focus groups and
presentations, work groups were formed to recommend strategies and action
steps for each section of the plan.
The Continuum of Care Plan also drew on information from strategic plans
‘including Beyond Shelter, the Twelve Point Plan, “One by One”, and numerous
reports including the 1993-94 CHAS, the 1993 Polaris Survey of Emergency
Shelters, the San Francisco Five Year HIV/AIDS Housing Plan, and the Five
Year Mental Health Housing Plan developed by the Corporation for Supportive
Housing and the SF Department of Public Health, and A New Beginning, a
document produced by the St. Anthony Foundation.
Continuum of Care Plan - Draft . Pagelé October 18, 1994
DESCRIPTION OF THE
HOMELESS POPULATION IN SAN FRANCISCO
The following information is the best information currently available on
homeless youth, families, men and women in San Francisco. The data was
compiled by the Homeless Youth Network, the Department of Social Services
(DSS), the Community Clinic Consortium of the Department of Public Health,
and the DSS Matrix Outreach Team. The information collected was self-
reported data on the homeless people in San Francisco who access shelter and
street outreach, and does not include data on the homeless people who do not or
cannot access these services.
The characteristics of the individuals and families using homeless services in
San Francisco are described in order to establish recommendations to address
the housing, health, social, economic, educational and employment needs of the
populations served.
Youth
The following data on homeless youth are based on the FY 1993-94 report of the
San Francisco Homeless Youth Network comprised of the following agencies:
Central City Hospitality House, Department of Public Health Special Programs
for Youth, Larkin Street Youth Center, and Youth Advocates. During 1993-94, a
total of 2,115 unduplicated homeless youth between the ages of 10-23 were
served in San Francisco. Of the total number of youth served, 89% were under 18
years of age and 11% were between 18 and 23 years. Of the youth served, 42%
were Caucasian, 23% were African American, 18% were Latino/a, 5% were
Asian/Pacific Islander and 2% were Native American. Of the total number of
youth served, 47% were female and 53% were male.
Families
Although there is no precise or unduplicated count of homeless families in San
Francisco, estimates are that families comprise 25-30% of the total local homeless
population. During FY 1993-94, based on unduplicated counts of families
applying for assistance through the DSS Homeless Assistance Program, there
were a minimum of 1,923 families who were homeless in San Francisco.
The following data was compiled by DSS between September 1993 and August
1994 on the 432 families who stayed at one of the four family shelters (Travelers
Aid-CCR Program, Hamilton Family Center, Raphael House and Richmond
Hills Family Center).
Family Histories
The families reported the following reason for their homelessness: eviction
(21%), relocation/resettlement (19%), inadequate income or employment (17%),
and domestic violence (15%). Nearly half (44%) of the families had a previous
Continuum of Care Plan - Draft Page 19 October 18, 1994
stay in another shelter. Of the total families served, 72% were marginally
housed or had come from another shelter prior to their current stay. Over one-
half of the families (53%) had lived in San Francisico for more than one year,
with 37% having lived in San Francisco for more than six years.
Family Status /Ethnicity
Of the total number of 432 families, 64% were single-parent households of which
55% were headed by single mothers and 9% were headed by single fathers. In
terms of ethnicity, 49% of the families were African American, 23% were
Caucasian, 16% were Hispanic, and 4% were Asian/Pacific Islander.
Ages of Children
The 432 families included 670 children with over half (57%) under the age of 5
years.
Income/Education /Employment
Almost two-thirds (65%) of the families were receiving Aid to Families With
Dependent Children (AFDC). In terms of educational and employment
experience, 41% of the parents had not completed high school, 23% had obtained
a high school diploma, and 21% had some college or credits or had received a
baccalaureate degree. Almost one-half of the mothers reported having no work
skills, while 26% had held a clerical or office
job.
Substance Abuse
Of the total number of families, 38% reported moderate to severe use of drugs
and alcohol.
Battered men’s Shelter
In addition to the four family shelters, there are three domestic violence shelters
(La Casa de las Madres, Asian Women’s Shelter, and Rosalie House). During
1993-94, these programs provided shelter to 253 women and 269 children. An
additional 1,464 women and their families were referred to the other four family
shelters due to lack of space in the battered women’s shelters. Of the women in
the battered women’s shelters, 34% were Caucasian, 29% were African
American, 26% were Hispanic, and 11% were Asian/Pacific Islander. Over half
of the children (54%) in the battered women’s shelters were under the age of five
years.
Men/ Women
The following information is based on data collected between April and June
1994 by DSS on the single men and women who used the seven shelters serving
homeless adults in San Francisco. These shelters include two Multi-Service
Centers (North of Market and South of Market), Episcopal Sanctuary, Central
Continuum of Care Plan - Draft Page 20 October 18, 1994
City Hospitality House, Salvation Army Lifeboat Lodge, the Dolores Street
Housing Program, and a Woman’s Place, operated by CATS at the St. Paulus
Lutheran Church. Between April and June 1994, information was collected on
1,242 homeless adults from these shelters, of which 25% were single women and
the remaining 75% were single men.
Age/Ethnicit
Over half of the men and women (63% for men and 72% for women) were
between the ages of 21 and 40, and 15% of the men and 10% of the women were
over 51 years of age. In terms of ethnicity, 50% of the women and 43% of the
men were African American, 39% of the women and 19% of the men were
Hispanic, and 1% of both women and men were Asian/Pacific Islander.
Histories
Over three quarters of the men (76%) reported their living arrangements as
being either on the streets or in shelters. Women’s living arrangements varied,
with 41% reporting that they lived on the streets or in shelters, and another 25%
that they lived in hotels or with family and friends. Over one half of the men
(57%) had been homeless for less than a year, while two-thirds of the women
(70%) had been homeless for less than a year. 17% of the men and 25% of the
women had been incarcerated in a state or county facility in the last year. The
men reported that the primary cause of their homelessness was loss of job (64%)
while the women identified mental illness (45%), substance abuse (24%), and
lack of income (16%) as causing homelessness.
Income
Sources of income varied, with 35% of the men and 31% of the women receiving
General Assistance (GA), and 32% of the women and 14% of the men receiving
SSI. (Social Security Income). Twenty-nine percent of the men and 18% of the
women reported no income. Although 40% of the men are veterans, no one
reported receiving VA benefits. Of the men, 4% reported that current income
came from part-time or full-time work, and 2% of the women reported similarly.
Employment Experience
Both men and women reported some work experience, with 72% of the men and
women having held a range of positions, from part-time jobs to full-time work
for five years or more. Half of the men (50%) reported working in unskilled jobs,
or in construction or hotel/restaurant fields. The women’s work skills varied,
with 23% of the women reporting no work skills, and 25% reporting that they
had worked at clerical /office jobs. Over half of the men( 64%) and women (59%)
had either attended high school or received a high school diploma. Eighteen
percent of the men and 20% of the women had some college attendance or had
received a college degree.
Continuum of Care Plan - Draft Page 21 October 18, 1994
Substance Abuse
Of the men, 40% self-reported current or past alcohol or drug use of a mild to
serious nature. Of the women, 61% self-reported current or past alcohol or drug use
of a mild to serious nature.
Other Disabilities
Over one half of the women (53%) reported a temporary or chronic mental
disability and 20% reported having an acute or chronic physical disability.
Of the men, 14% reported an acute or chronic mental disability while 22% reported
a temporary or permanent physical disability.
DSS Matrix Outreach Team Data
Limited information is available about the homeless adult population who do not
use shelters. The DSS Matrix Outreach Team has collected information since
October 1993 on the 588 homeless men and women who were housed at the
Mission Hotel. Over half (53%) of the men and women interviewed by the DSS
outreach workers had been in San Francisco for more than two years; 38% had been
homeless for less than one year. Three quarters of the single adults (75%) lived on
the streets or in the parks. More than one-half (57%) of the respondents identified
the need for substance abuse services while 26% reported a need for mental health
services. For sources of income, 29% reported receiving GA, 22% were receiving SSI,
and 46% reported no income.
Community Clinic Consortium Data
Further data on homeless men and women contacted on the streets during 1993
were available through the Street Outreach Services Program of the San Francisco
Community Clinic Consortium. Of the 1,716 homeless clients contacted, 80% were
male and 20% were female. In terms of ethnic breakdown, 42% were Caucasian, 38%
were African American, 17% were Latino, 1% were Asian/Pacific Islander and 1%
were Native American. Of the total number of contacts, 86% were single (84% adult
and 2% Youth). Of the people contacted, 14% were within a family (13% adults and
1% youth). In terms of living conditions, 21% reported living in a shelter, 10% in a
transitional housing program, 4% were living doubled up, 60% were living on the
street, a vehicle or make-shift housing and 5% reported other locations.
Summary
Although the data on youth for this first draft is limited, it is noteworthy that there
is almost an equal number of homeless girls as homeless boys.
Almost two-thirds of the families in the shelters are single parents with the
Continuum of Care Plan - Draft Page 22 October 18, 1994
majority being female headed households. Two-thirds of the families are receiving
some form of public assistance, almost one half have not finished high school
andone half do not have any work skills. On the other hand, about one-fourth of
the single parents had had some college or had received a BA degree. Particularly
striking is the significant number of homeless children who are under five years of
age.
Of the single adults in the non-family population, most were receiving public
assistance and one third of the men were receiving no income at all. Almost three-
quarters of the single adults in the non-family population had some employment
experience, although most were employed in unskilled jobs. In general, more of the
single adults had completed high school than had women and men in the family
population. On the other hand, 21% of the adults in the family population had
some college or a college degree, while 18% of the single men, and 20% of the single
women had some college or a college degree.
Substance abuse was higher in the single adult population than among the families.
Of the men in shelters, 40% reported current or past drug problems, while 61% of
the women reported similarly. Of the single men and women contacted on the
streets, 57% expressed a need for substance abuse services. The incidence of mental
illness was higher among single women than single men, with over one-half of
the single adult women reporting a mental disability. Between 10% and 15% of the
single men and women in shelters are over 51 years of age.
Based on this very limited data on some of the characteristics of the individuals
and families who used homeless services in San Francisco at some time during
1993-94, some tentative conclusions can be drawn. Substance abuse is a significant
problem and the Continuum of Care will be unsuccessful if this problem is not
addressed. Lack of education and job experience are significant barriers to self-
sufficiency, and educational and on-the-job training must be a priority. Subsidized
childcare for parents enrolled in vocational and educational programs will be a
necessity. Supportive housing programs for people with mental disabilities will be
essential to help members of this population achieve personal stability. Finally,
employment opportunities for the single adult population must be a core strategy
for helping these individuals gain independence.
Continuum of Care Plan - Draft Page 23 October 18, 1994
Summary of Data on Families Staying in Shelter
(9/93 - 7/94)
N=432 Families
Family Status Race-Ethnicity
EiSingle
With
Partner
GiMarried
Divorced
TU aise Dos eee eas |
Education
i partial HS
WHS graduate
EiCollege
45%
Es Other
Work Skills
Unskilled Children's Age
@Clerical/ Off
12%
19% GO) Manu/Sales/
Tech/Med
Continuum of Care Plan - Draft Page 24 October 18, 1994
Summary of Data on Men Staying in Shelter
(4/94 - 6/94)
N=928
Race-Ethnicity
Income
None
HM General
Assistance
O SSI.
El Other
Education
K-12 (no HS
diploma)
@ High School
Diploma
Continuum of Care Plan - Draft Page 25
& African
American
7%
@
Caucasian
O Latino
Work Skills
Unskilled
@ Construction
DLH&R/Office/
Tech/Ed.
E3 Other
a
Alcohol and Drug Use
i Mild/Serious
Use
O Unknown
October 18, 1994
Summary of Data on Women Staying in Shelter
(4/94 - 6/94)
N=318
Race-Ethnicity
F21-30
31-40
£141-50
E151-70
Income Work Skills
None
@ Unskilled
I Office/
Const/
Manu./Tech
Other |
*
Alcohol & Drug Use
Education
3 K-12 (no HS
diploma)
BHigh School
Diploma
OSome
college/
degree
Ei Other
Continuum of Care Plan - Draft Page 26 October 18, 1994
Yolq - uvjd avy fo unnuyuor
LT 280g
P66L ‘BL 4290390
HOMELESS PEOPLE- ON
STREETS
FORMERLY HOMELESS
PEOPLE
PEOPLE AT RISK OF aN
BECOMING
HOMELESS
HEALTH SEAVICES, CRISIS INTERVENTION FAMILY pi aca See
SERVICE
SUPPORT, EDUCATION, RENTAL SUBSIDIES, OUTREACH SS
EVICTION PREVENTION, LEGAL SERVICES, JOB
OPPORTUNITY
DETOX, ASSESSMENT,
CRISIS INTERVENTION,
SHELTER, HOTELS,FO@D
q
\
4
FOLLOW-UP and TRANSITIONAL ,
HOUSING and
SUPPORT
SERVICES
SERVICES
EMPLOYMENT TRAINING and
PEER SUPPORT, COUNSELING,
. PLACEMENT, EDUCATION, MENTAL
TREATMENT, COMMUNITY
HEALTH and SUBSTANCE ABUSE
TRANSPORTATION PERMANENT
. HOUSING,
EMPLOYMENT oo
AND SUPPORT r
~ SERVICES a
~~ ™ a
— jen <— - +
CONTINUUM OF CARE
SAN FRANCISCO
Continuum of Care Plan - Draft Page 28 October 18, 1994
FISCAL ANALYSIS OF 1993-94 HOMELESS FUNDING
The purpose of the fiscal analysis was twofold. First was to identify the uses and
sources of homeless funds in the public and private sectors in San Francisco.
Second was to assess current fiscal spending patterns and gaps in services in
order to make funding and service recommendations for the proposed
Continuum of Care.
Fiscal data on homeless services funded by City departments for FY 1993/94
were compiled by the Mayor's Fiscal Advisory Committee (MFAC). These
figures included expenditures that were allocated from the City to the non-profit
sector. The information on homeless expenditures and services in the non-profit
sector for FY 1993-94 was compiled by Polaris Research and Development
(Polaris). The fiscal information collected from the non-profit sector included all
non-City funding, that is funding that came directly to the non-profits from
federal, state, and private sources. The MFAC data describes budget information
on all relevant City departments. The MFAC and Polaris fiscal analyses were
combined to produce the figures on the total expenditures for homeless services
in San Francisco.
Polaris collaborated with the MFAC/Polaris subcommittee of the Mayor’s
Homeless Budget Advisory Task Force in identifying the agencies to be
interviewed. The 47 agencies surveyed are a sample of the non-profits providing
services to homeless persons. The subcommittee believes it is a representative
sample, as well as one that includes all key non-profits providing relevant
services.
Findings
Fiscal Analysis
How Public and Private Dollars are Spent on Homeless Services
Fiscal data were collected under several categories and analyzed several ways.
First, data were broken down by four major demographic groups: men, women,
families, and youth. Second, expenditures were divided between core and
ancillary programs. Core programs are those specifically designated to serve
homeless persons. Examples of core programs are shelters, transitional programs
for homeless families, or clinics, such as Tom Waddell, which provide health
care to homeless people. Ancillary programs are defined as those that are
targeted toward low-income persons, but some percentage of the services are
used by homeless persons. An example of an ancillary program is San Francisco
General, which provides health care to low-income people including homeless
people. Third, figures were broken down by the major components of the
continuum--prevention; emergency services including health care, outreach and
Continuum of Care Plan - Draft Page 29 October 18, 1994
shelters; transitional housing and services; and permanent housing.
Every attempt was made to secure precise expenditures for homeless services.
However, it must be emphasized that not all agencies record fiscal data in the
same way, and in some instances it was not possible to obtain detailed
information. When a department or agency could not provide precise figures,
respondents were requested to give their best estimate of the expenditures.
Although the fiscal data presented below are not perfect, they represent the most
complete information available.
For the FY 1993-94, approximately $79.9 million from General Fund, federal,
state and private sources was incurred for homeless services in San Francisco.
These expenditures represent $56.1 million that flowed through City
departments from General Fund, federal, and state sources, and $23.8 million
expended by non-profit agencies from non-City sources. (See Exhibit 1). Of the
$56.1 million that flowed through the City’s departments, $38.8 million came
from the City’s General Fund, $2.4 million came from state sources and $14.6
million came from federal sources. The $56.1 million expended by City
departments includes expenditures to non-profit agencies for homeless services.
Of the $23.8 million expended in nonprofit agencies, $20 million came from the
private sector, $3 million came from federal sources and $800,000 came from
state sources. (See pie chart.)
Exhibit I also indicates that in addition to the $79.9 million spent during the year
for homeless services, there was an additional $16.2 million incurred by the San
Francisco Redevelopment Agency and the Mayor’s Office of Housing for the
acquisition and construction of low-income housing for homeless persons. As
these are "one time" charges to build long-term facilities, they are not included in
the regular operating budgets but are rather amortized over the useful life of
these facilities. Funding for these facilities came from federal funds ($10.2
million) and from tax increment funds ($6 million.).
It is important to point out that of the total $79.9 million (including city, private,
federal and state funds), $46.2 million (or 58%) was for "core" expenditures--that
is for services specifically designed for and dedicated to homeless persons. By
contrast, $33.7 million (or 42%) were for "ancillary" services--that is, services for
low-income persons but also used by homeless persons. For example, the City’s
General Assistance Program (GA), provides GA payments to 15,000 adults, of
which 3,000 are homeless. For those 3,000 homeless adults, the GA program
spent $11.3 million, which includes $10.5 million in direct GA payments to
homeless persons, and $790,265 in administrative and indirect costs. In
addition, $8.9 million in ancillary funds from the Department of Public Health
was spent on homeless persons.There is significant variation in funds expended
for services along the Continuum of Care. As shown in Exhibit II, expenditures
Continuum of Care Plan - Draft Page 30 October 18, 1994
on eviction prevention, $949,509, were lower than for all four main demographic
categories. The most funds are expended for clients in shelters-$27.8 million.
The next highest level of funding is for homeless persons on the streets and in
public places--$22.6 million. Funds expended for services in transitional and
permanent housing are less significant--$14.5 million and $5.3 million
respectively. Thus, over one-half of the monies expended, $50.4 million or 63%
are for emergency services, including shelter services for people living in streets,
and public places. Significantly less money is spent at the extreme ends of the
Continuum of Care. Eviction prevention funds total $950,000 or about 1%.
Services for permanent housing total $5.3 million or 6.6% of the total (excluding
capital expenditures).
However, care must be given to drawing conclusions as to the funding amounts
along the Continuum of Care as shown in Exhibit II. In the Department of
Public Health, for example, data are generally not kept based on the housing
status of the client. Therefore, the Department of Public Health placed all of the
costs it could not specifically segment into the "Street and Public Space"
category. Similar problems were faced by the Department of Social Services in
trying to break down by location on the continuum the General Assistance
payments for homeless recipients.
Efforts were also made to try to segment costs of the homeless population into
four demographic categories--single men, single women, families, and youth.
Unfortunately, most city departments do not keep such detailed information on
the homeless population (in budgetary records) and due to this lack of data, no
conclusions could be reached.
As mentioned above, each City department and non-profit service provider was
asked about expenditures for a variety of homeless services. Exhibit III shows
the expenditures for different categories of services for City departments. The
Department of Public Health and the Department of Social Services were the two
city departments with the highest expenditures for homeless services--$28.7
million and $21.5 million respectively. The primary service expenditures of the
Department of Public Health were $8.4 million for substance abuse treatment,
$3.4 million for mental health treatment, $10.5 million for medical services, and
$1.1 million for counseling and case management. The primary expenditures for
the Department of Social Services were $4.8 million for shelters, $10.5 million for
General Assistance payments to individuals, and $2.3 million for counseling and
case management.
Non-Profit Agency Expenditures
Among the 47 non-profit agencies, total expenditures from federal, state, and
private sources for homeless services among both core and ancillary programs in
FY93/94 was $23.8 million of which $21.5 million was in direct services and $2.4
Continuum of Care Plan - Draft Page 31 October 18, 1994
million in indirect/administrative costs. Indirect/administrative costs were
generally calculated by the non-profits based on the maximum limit specified by
the City department with which they have contracts (typically 10 to 12%).
However, most respondents stated that their indirect costs were actually higher
than listed.
The expenditures along the Continuum of Care by non-profits of the non-City
funneled funds ( which include Federal, State, and private funds) generally
parallels expenditures for all funds combined. Specifically for core services, $3.5
million was expended on homeless persons on the streets or in public places and
$6.7 million was expended for persons in shelters or emergency hotel visits for a
total of $10.1 million on the emergency services segment of the continuum.
Transitional housing expenditures appear to be relatively high ($8.4 million). A
significant part of that sum, however, is due to the inclusion of residential
substance abuse treatment programs in the transitional housing category. Of the
$8.4 million in transitional housing expenditures, $1.9 million (23%) is for
substance abuse treatment in a residential setting.
Relatively little in non-City-funnelled funds is spent at either end of the
Continuum of Care. For prevention services, $228,796 was expended by the non-
profits. For permanent housing services, $19 million was expended. Thus,
expenditures in the non-proft sector parallel the expenditures of City
department funds with the bulk being spent on emergency services, and
relatively little spent on either prevention or supportive housing.
Polaris collected separate fiscal information on the various sources of funding in
the non-profit sector excluding the City or City -funneled funding. The
percentage of non-City or City-funneled funds among the non-profits is broken
down as follows:
Non-City Funding Sources Percent
State 6)
Federal 13
Foundation 14
Corporation 5
Private 47
Other 18
The largest single category (47%) is "private" donations, the bulk of which are
private charitable contributions. (Included in private funds are monies from the
United Way, which comprise 3% of the total funding.) Corporations contribute
significantly less than foundations (5% compared to 14%). Direct federal
funding accounted for 13% of the total. A significant proportion of the federal
funds came from the Center for Substance Abuse Treatment to fund treatment
Continuum of Care Plan - Draft Page 32 October 18, 1994
programs. Much of the state funding came directly from the Office of Criminal
Justice Planning for agencies serving battered women.
The figures quoted above represent all funds that could be specifically identified
as coming from one of the enumerated sources. However, a few agencies could
not readily distinguish between foundation, corporation, or other private funds
(about 7% of the total). These aggregated monies were included in the "other"
category. The "other" category also includes several alternative sources of funds,
such as program fees, money generated from agency businesses, and dividends
from stock portfolios.
The 47 non-profit agencies surveyed for this study included 17 shelters, 8 |
housing programs, 7 programs providing counseling and support services, 6
substance abuse or mental health treatment program, 3 vocational training
programs, 2 rental assistance programs and 3 other (food, etc) programs.
Four of the agencies serve exclusively men, two serve exclusively women (not
counting women with children), five serve exclusively families, and three serve
exclusively youths. The remaining agencies serve some combination of the
"men, women, youth and families. Family programs serve smaller children who
are accompanied by a parent and youth programs serve older children (typically
runaway teenagers) not accompanied by a parent or guardian.
More agencies serve men than any other demographic category, and the most
non-City funneled money, $9.4 million is spent on single men. Although there
are more programs that serve women than serve families, significantly more
non-City-funnelled funds are expended on services for families ($7.3 million
compared to $4.7 million for women). The four non-profits that target youth
spend $1.4 million.
Summary of Polaris Report on Service Gaps
Generally speaking, the 47 respondents from the non-profit agencies surveyed
identified the need to expand mental health and substance abuse services,
increase transitional and permanent housing with associated support services,
and expand educational and vocational training opportunities combined with
job development. Respondents stressed the need to provide prevention services
including eviction prevention and other services designed to keep people
"housed." Greater emphasis should be given to substance abuse prevention,
smoking prevention, AIDS prevention, and other health-related prevention
programs. Greater coordination should be required among the agencies that
feed into the homeless service delivery system including jails, hospitals and
treatment programs
Respondents generally agreed that further dollars spent on outreach without
Continuum of Care Plan - Draft Page 33 October 18, 1994
enhancing treatment services would create more serious bottlenecks in the
system. A single computerized intake and information system available at
selected sites around the city is preferable to a single point of entry.at a single
location. Expanded or enhanced assessment of clients who enter the system was
recommended. The assessments should include a "service plan" for each client. —
Respondents identified the need for more low-income housing for persons with
mental health problems and substance abuse disabilities as well as housing for
persons who can live independently, but cannot afford market rate rents. Most
respondents believed that a significant proportion of clients needed housing
associated with support services.
Respondents agreed that more follow-up of clients is needed to ensure
continuity and prevent relapse. There is also a need for greater coordination
among the various agencies to provide more comprehensive and continuous
health and support services for homeless persons. Respondents reported on the
need for more services for individuals with one or more disabilities, such as
psychiatric disability, substance abuse disability, or HIV+. Respondents also
reported the need for more opportunities and services related to educational,
vocational, job training, and economic development for homeless individuals
and families.
Continuum of Care Plan - Draft Page 34 October 18, 1994
Summary Tables
| tavoreomotns once | sare ||| sitar | tarer |
[mayors omtenconm ow | || soraee | tarsaee || sara |
ee
| wavors com sustcncounes | rare || Pere | Teas
ee ee ee
ie nena mom | te ND [roe [ee ose | dsc
DSS - Aid to Families with Depen. 127,872 437,739 957,993 957,993
Children
Dept. of Public Health 15,125,556°) 1,829,539 11,375,416 326,920 10,097,170 8,923,658 19,020,828
een ee ee eee ee ee
ee
Lom-sramm | | ee | je | see |
Foncstsmene concn | eee [| | ee | |e |
ea nl a | al (ee ee
[comm onsunusotwonen | sisato | ramos | | Lee Sees
ee as ee
ee
lessen
[bom otnecs eras | sus | | |
STE annEEEEEEE ee aE
[Nottortrom serv Proves || sranast_| saouses fsosra700 | Peace [ome | ee |
“ All expenditures include direct and indirect (administration and overhead) expenditures.
) Based on discussion with the Office of the Board of Supervisors Budget Analyst.
® Funding sources are for both Core and Ancillary Costs. ,
Fa = $5,994,145 $10,206,879 $16,201,024
“ These costs represent the acquisition and construction of low income housing in FY 1993-94. As these costs are "one time" charges
to build long-term facilities, they would not appear in the operating budget but rather be amortized over the useful life of these
facilities.
Continuum of Care Plan - Draft Page 35 October 18, 1994
| Expenditures by Source of Funds
2 by Percent of the Total $79,922,764
[Mayors Homeises orice | | star |
[Moco (cor) | arsisen | zaso0| rao | arts | | 280 |
pmon(corm) | asco | camara | 208512 |
wesc com) A A DP kat | aes |
foss(cor) | teases | ase.osz | sa.rs0 | sao.ars | ters.9e7 | 450.911 |
[oss (ancitay) | oso | | tnzsaas | | aaszoe | rz |
ppraicory | | arenas | sirens | 1.70008 | aesar | 1.447650 |
[opa(ancitayy | | nsa.zvz | | asa.t00 | 755,002 | a c4neao |
Pieisentntenel psf
ee a ee
Comm. on Status of Women
(Core)
Sheriff & Police Ce ees | eee
eee oie |e
ew Sc ee im |
[Deparmental To's | __s7ao7ta | sigoszara | saooaze7 | $5,722,607 | sazis.ic0 | ss.1a.e66
Not-for-Profit Service
Providers (Core) 228,796 3,455,238 6,674,245 8,358,896 1,866,175 2,241,764
(Ancillary) 3,000 234,816 399,103 235,234 121,539
TOTAL $949,509 $22,550,552 $27,858,328 $14,480,666 | $5,316,539 $8,777,169
® Services Only
®) Data is not kept, in general, on where the client is housed (street and public space, shelter, etc.) by program. Where this information
is not broken down, the funding is shown in "Street and Public Space".
Continuum of Care Plan - Draft Page 37 October 18, 1994
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CONTIN VU UM OF CARE
SAN FRANCISCO
DESCRIPTION OF CONTINUUM OF CARE
FIVE YEAR STRATEGY
(1995-2000)
The Continuum of Care is an integrated and comprehensive system for assisting
individuals and families who are homeless or at risk of homelessness.
As the preceding diagram illustrates, the continuum is composed of five major
components: Prevention, Emergency Services, Transitional Housing and
Services, Permanent Housing, and Follow-Up and Support Services. These
components identify the essential elements of a system for addressing the needs
of individuals and families who are homeless or at risk.
The interaction among the components is critical to maintaining open access
throughout the system. Although there is a natural progression from one
component to another, as from emergency services to transitional services,
access to the system is not necessarily in a fixed order. The Continuum of Care
diagram describes an overview of a system, rather than a path that each
homeless individual or family must travel. The system is intended to have the
flexibility to accomodate to individual skills and capacities.
As the Polaris/MFAC report described, existing policies and expenditures have
focused on entrances such as emergency services to the exclusion of exits such as
permanent housing. As a result, people stay unnecessarily in shelters, or recycle
through services, because alternatives do not exist. The Continuum of Care must
ensure that people who are able, move as quickly as possible, to the greater
levels of responsibility and independence which permanent housing, training
and employment would provide. It is essential that people have opportunities to
build the skills and self-esteem necessary to return to the mainstream.
Many individuals and families will require long-term care and support. The
continuum is intended to assist these individuals to move out of homelessness
and into transitional or permanent living environments. These environments
will provide more integrated living opportunities as well as greater access to
supportive networks than do shelters.
A number of essential services will cut across all five components. These include
substance abuse and mental health treatment, employment services and follow-
up support services. Substance abuse is a significant problem among many
homeless people as confirmed by the data described in a prior section. The
Continuum of Care will be unsuccessful in reducing repeated uses of homeless
services if this problem is not addressed. Treatment and support services will
have to be available throughout the continuum to ensure access to preventative
Continuum of Care Plan - Draft Page 41 October 18, 1994
and emergency treatment, residential care and outpatient treatment, and services
connected to housing. Employment services including job readiness, vocational
and job training, and job placement are critical to ensuring permanent exits and
will also be included along the continuum. (See Employment Section).
Description of Components
The five core components of the continuum are:
Prevention
To address housing, health care and support service needs before they emerge in
crisis form. Prevention strategies promote health, reduce costly emergency and
psychiatric hospital admissions, forestall the loss of housing, and ultimately
decrease the number of individuals and families entering the homeless system.
Emergency Services
To provide accessible, efficient and integrated health care, and shelter and
support services, to reduce crisis situations and to provide access to the next
level of treatment, housing and support that is necessary.
Transitional Housing and Services
To provide a transition for individuals, youth and families who have substance
abuse, mental health and/or personal problems which need to be addressed
before they are able to move to permanent housing.
Permanent Supportive Housing
To provide housing and support services so that individuals and families can
maintain residential, economic and personal stability and develop the support
networks that ensure self-sufficiency.
Follow-up and Support Services
To ensure that each person has the opportunity to access the housing, treatment,
employment and support services to maintain personal and/or family stability
and to monitor the success of the system and the individual in reaching these
goals.
Each component section includes a goal statement followed by the strategies and
actions needed to reach the goal. Many of the recommendations are identified
along population categories: adult men, adult women, families with children,
battered women, and youth. When not specifically designated,
recommendations are for all populations of homeless people.
Because this is a first draft, each element section identifies strategies and actions
without detailed explanation of who is responsible for implementation or for the
Continuum of Care Plan - Draft Page 42 October 18, 1994
costs associated with the recommended action. These details will be included in
the second draft of the report.
Description of the Continuum of Care Service System
Current homeless services are delivered through a loosely linked network of
public and private programs rather than a cohesive system which works for the
benefit of the individuals and families served. Insufficient coordination of health
and support services for homeless people was mentioned as.a serious gap in the
Polaris survey of non-profit providers.
Critical to the success of the continuum is the integration of health services, and
the coordination of housing, health and support services. Integration of primary
care and substance abuse and mental health treatment is identified as a strategy
for each component of the system. Integration of homeless and mainstream
services will be a core strategy of the service system. As supportive housing
programs are developed, it will be essential that the system establish
mechanisms for the integration of housing, health care and support services. The
importance of centralizing support service funds in order to access
interdisciplinary services through one funding source is described in the
Housing Component.
The continuum must ensure that health care is delivered through an integrated
system of primary health, mental health, and substance abuse treatment services.
As managed care is enacted it will be important to maximize revenues and
incorporate the health services recommendations of the Continuum of Care
Plan. Health services must accommodate homeless and at risk people who have
one or more disabilities including substance abuse and/or mental health
problems, and/or AIDS/ HIV+. It is essential that the system deliver services at
the time that the services are requested.
Current departmentalized delivery of health services is not effective for
homeless people needing multiple kinds of health care. The current system of
separate intakes and assessments within the divisions of mental health,
substance abuse and primary care does not serve homeless people well.
Departmental mechanisms will be established to ensure that this integration
occurs.
Each homeless person will have a Primary Health Care Provider to assess and
monitor substance abuse, mental health and medical problems and to foster a
long-term primary care relationship.
In addition, liaison workers located at health care entry points such as San
Francisco General Emergency Room, substance abuse treatment centers, and
Continuum of Care Plan - Draft Page 43 October 18, 1994
other homeless entry sites will ensure that people gain access to the housing,
treatment, employment and support services for which they are eligible. The
liaisons will be responsible for intaking new people into the system, and for
contacting counselors with whom individuals are already working. In addition,
the liaison worker will coordinate health care and social services, including
access to entitlement benefits, as well as the status of housing placements and
employment services. The liaison worker will fill a monitoring role to be sure
that people, particularly those who are disabled or dysfunctional, do not fall
through the cracks.
It is recommended that each homeless person in the system have a
Comprehensive Homeless Assistance Plan (CHAP) developed by the individual
and the liason worker or a counselor with whom the individual or family is
already working. The CHAP will ensure follow-up on housing status,
employment services, progress in treatment programs, and support services.
Consideration will be given to building on the centralized assessment and
referral system of the Target Cities Program of Community Substance Abuse
Services, a program of the Department of Public Health, to provide assessment
and monitoring of the CHAP and of progress in treatment programs. Linkages
to the Housing Data Base for the delivery of housing, health care, and support
services will be developed.
Integrated health services will be facilitated through the development of Health
Care Associations (HCA’s). The HCA’s will consist of multidisciplinary health
care teams, including primary care providers, responsible for providing one stop
health care to homeless people. The HCA’s will be located at multiple entry
points including neighborhood health centers, and mental health cluster sites
such as Tom Waddell clinic.
The continuum will provide services to individuals and families in the least
restrictive environments and with as much flexibility and choice as is possible.
Services at all sites will be provided in an atmosphere of safety, acceptance and
cultural sensitivity.
Training in cultural competency for health care and support service staff will be
provided to address the diversity of the homeless population. Services will be
tailored to meet the needs of special populations including women, sexual
minorities, the mentally disabled, immigrants, transgender populations, and
dually and tripally diagnosed people (substance abuse, psychiatric disability,
AIDS/HIV+).
Services will be easily accessible, and as much as is possible, neighborhood-
based.
Continuum of Care Plan - Draft Page 44 October 18, 1994
The strategy and action goals identified in this section cannot simply be met
with better coordination or restructuring and refocusing of services. Increased
capacity and leveraging of new funding sources are essential to delivering a
- continuum of health and social services.
Description of the Following Sections
The following sections of this plan describe the Continuum of Care Five Year
Strategy. Strategies and action steps are identified for each of the five
Continuum of Care components: Prevention, Emergency Services, Transitional
Housing and Services, Permanent Housing, and Follow-up and Support
Services. In addition, the Strategy includes an Employment and Training Plan,
and a Civil Rights Plan. The final section describes the Continuum of Care
Management Plan which outlines a strategy for governing all homeless policy
and budget decisions in San Francisco.
PREVENTION
FIVE YEAR STRATEGIES
Prevention is key to addressing homelessness. Preventative strategies focus on
the causes of homelessness: insufficient income to meet housing costs, lack of
education and employment skills, substance abuse and/or mental health
problems, domestic violence, discharge from institutional and residential
facilities with no place to live, and lack of community supports.
The goal of prevention is to reduce the number of individuals and families who
become homeless. To accomplish this goal individuals and families must be able
to maintain residential and economic stability; access substance abuse, mental
health, medical, social and legal services; gain educational and job skills; and
have access to family or community support networks.
Strategy 1
Centralize Housing Information
Action Needed - Establish a HOUSING DATA BASE to assist in securing
housing for individuals and families about to lose housing, living in
~ overcrowded or unsuitable conditions, or leaving shelters, transitional or
residential programs or institutional settings. Information will be included on
HUD funded units, Public Housing Authority units, private market housing,
supportive and transitional units, Shelter Plus Care units and shelter bed
availability. The system will be accessed at different entry points throughout the
city. Other existing on-line housing and information systems, such as
Continuum of Care Plan - Draft Page 45 October 18, 1994
Independent Housing-AIDS Housing Network and the proposed INFOLINE
(See Emergency Services Element), will also be made available at these sites.
Strategy 2
Prevent Eviction and Loss of Housing
Action Needed - Expand funding for the Homeless Prevention Fund
administered by American Red Cross and Rental Deposit Guarantee Fund
administered by Catholic Charities. Funds will be used to prevent eviction, assist
with move-in costs for new housing, and back rent payments, and include
housing costs when an individual temporarily loses benefits or income due to
hospitalization or treatment. Support existing efforts such as the Home Stretch
Initiative to raise $150,000 a year over three years to supplement the Homeless
Prevention Fund and Rental Deposit Guarantee Fund, and expand other eviction
prevention strategies. Funds are needed for rental assistance programs and staff.
Action Needed - Expand eviction prevention strategies for families and
individuals in subsidized housing such as early eviction notices, landlord
mediation, direct rent payment, and monitoring of substance abuse and mental
health problems to prevent eviction. Utilize the Section 8 program of Project
Homeward Bound as an effective example. Publicize rental assistance
information at neighborhood centers/entry points.
Strategy 3
Prevent Institutional Discharge Patterns Which Lead To Homelessness
Action Needed - Establish discharge policies at local hospitals, jails, and
residential drug, alcohol and mental health treatment facilities to ensure that no
one is discharged from an institution or program without housing. Link
institutions with Housing Data Base to facilitate housing placement. Ensure that
the Housing Data Base is accessed by shelters, jails, youth group and foster
homes, mental health and substance abuse residential settings, hospitals and
other designated community agencies.
Strategy 4
Expand Access to SSI Eligibility and Money Management Services For SSI
Recipients
Action Needed - Expand on “One Stop Shop” recently established by DSS and
DPH. Provide assistance for GA recipients eligible for SSI in processing
applications. Establish incentives for non-profits to expand capacity for assisting
with SSI application process. Expedite GA recipients eligibility for SSI. Work
with local and federal SSI representatives to streamline SSI applications.
Outstation SSI representatives at neighborhood sites and shelters.
Action Needed - Expand community based rep payee services for SSI recipients.
14% of men and 32% of women living in shelters are SSI recipients, and 22% of
Continuum of Care Plan - Draft Page 46 October 18, 1994
homeless people contacted on the streets by DSS outreach workers are on SSI.
Recipients of SSI find it difficult to secure rep payees or they have rep payees
who do not act in their best interests. Expand rep payee services at:
neighborhood sites. Encourage volunteer and church groups to take on rep
payees. Lobby federal government for fiscal support to insure that SSI recipients
get rep payees. Funds are needed to expand existing system and for support
staff.
Strategy 5
Provide Immediate Response to Emergency Legal Problems That Threaten
Family and Individual Stability
Action Needed - Expand availability of emergency legal and advocacy services
for persons faced with: Immediate eviction; domestic violence, loss of or
problems with public benefits (including GA, SSI, AFDC, food stamps,
MediCal); and other legal problems including immigration or lost documents.
Strategy 6
Provide Centralized Intake For Families
Action Needed - Establish a Family Support Center with a 24 hour hotline for
families threatened with losing housing. Provide centralized intake for homeless
and at risk families. Services will include a centralized housing data bank,
housing location assistance, rental assistance, counseling, landlord and family
mediation, early eviction warning procedures, and legal assistance. Access to
food boxes, food vouchers, benefits advocacy, childcare, and modified rent
payment program. Redirect staff from DSS AFDC Programs, existing homeless
prevention programs and Housing Authority to provide services at one site.
Strategy 7
Collaborate on High-Risk Families
Action Needed - Establish mechanism for collaboration between Continuum of
Care planning for high-risk families and DSS Family Preservation Program and
related programs of DPH, MOCYF, SFUSD, the Housing Authority, and the
Police Department.
Strategy 8
Provide Accessible and Integrated Health Care Services to Prevent
Deterioration of Health and Loss of Housing
Action Needed - Provide each homeless person with a primary health care
provider to assess and monitor progress of substance abuse, mental health or
medical health needs and to establish a long-term primary care relationship.
Create a continuing care and relapse prevention unit with follow-up support
services at housing sites for formerly homeless people in order to prevent
serious health problems and loss of housing. Expand health care outreach at
SRO’s, and supportive housing sites to prevent eviction.
Continuum of Care Plan - Draft Page 47 October 18, 1994
Action Needed - Expand on assessment and referral system of Target Cities
Program of Community Substance Abuse Services to provide intake assessment,
monitoring of the CHAP and early intervention of medical, mental health and
substance abuse problems.
Action Needed- Create 100 outpatient treatment slots for homeless individuals at
risk of alcohol and drug relapse. Create an additional 100 outpatient treatment
slots for integrated substance abuse, mental health and primary care services to
prevent relapse for people who are dually and tripally diagnosed.
Strategy 9
Prevent Homelessness Among Youth Turning 18, and/or Leaving DSS Group
Homes, Foster Homes or Probation System.
Action Needed - Ensure that youth exiting group homes and foster care have a
permanent residence to go to and are prepared for independent living. Work
with DSS and Probation to establish adequate referrals for placement after care.
Work with DSS to allow grace period for youth turning 18 or graduating high
school and allow youth to use own savings to stay at placement (especially if bed
is available) until permanent housing is found. Enforce savings plan for youth
who are working and about to exit group or foster homes.
Action Needed - Work with DSS and DPH to increase access to Medi-Cal
eligibility services for youth and providers, and SB910 funds for youth social
services.
Strategy 10
Prevent Runaways, Reduce Family Violence, and Prevent Homelessness
Among Runaway Youth
Action Needed - Utilize existing respite shelter and family reunification
program as model of family counseling. Restore neighborhood-based family
centers. Provide peer mediation and counseling at all junior and senior high
schools.
Continuum of Care Plan - Draft Page 48 October 18, 1994
EMERGENCY SERVICES
FIVE YEAR STRATEGIES
Emergency services are short-term responses to meet critical need. Emergency
services provide immediate access to food, shelter, health care and support
services. Services include street outreach; detox; crisis intervention; emergency
substance abuse, mental health and primary care services; food, clothing and
emergency shelter. Information services for homeless people, and the public at
large, are also included in the emergency services element. Emergency services
are intended to move people as quickly as possible out of crisis to the
transitional and permanent housing and services that are necessary.
Strategy 1
Immediate and Accessible Information
Action Needed - Establish an InfoLine --one information phone number on-line 7
days a week and 24 hours a day-- accessible to homeless people and the public at
large. The InfoLine will have capacity to manage approximately 50,000 calls per
month. The InfoLine will provide information on crisis assistance, emergency
services including shelter ,GA information, drop-in and detox centers, health
clinics, treatment programs, educational and vocational programs, legal
assistance programs, and volunteer opportunities. Funds needed to establish
system.
Strategy 2
Centralize Intakes for All Housing Services for Adult Men and Women to
Increase Accessibility and Efficiency of System
Action Needed- Establish a wide-area network on-line computerized
information system for intake into emergency shelters and housing programs.
Centralized intake means centralization of information and not a single entry
point of entry. Integrate CHAP into system. Ensure confidentiality.of
information. Link the intake system to Housing Data Base (See Prevention
Element). Create access to multiple data bases at treatment centers, designated
community, homeless and health centers, and institutional settings. Assess
capacity of Target Cities Information System for incorporating this network.
Strategy 3 |
Gradually Reduce Shelter Capacity For Adult Men and Women as Supportive
Housing Is Developed (See Housing Component).
Action Needed - As supportive housing and treatment capacity are expanded
and demand for shelter decreases, efforts should be made to reduce emergency
shelter capacity. As shelter capacity is reduced, redirect existing shelter support
staff from emergency shelters to supportive housing programs. Mandate service
provider meetings through contracts to increase coordination between shelters,
Continuum of Care Plan - Draft Page 49 October 18, 1994
supportive housing programs and mainstream programs.
Action Needed - If approved by voters, monitor Mandatory Direct Rent
Program to assess impact on availability of shelter beds and hotel conditions.
Strategy 4
Increase Capacity to Provide Emergency Housing for Mentally Disabled Men.
Action Needed - Provide an additional 40 emergency housing beds for mentally
disabled men.
Strategy 5
Provide Integrated and Accessible Emergency Health Services
Action Needed- Establish integrated health care delivery for homeless people
through HCA’s (multi-discipinary health care teams) located at existing health
centers and/or at sites in neighborhoods where assistance is most needed.
Ensure that the HCA’s are integrated into other DPH programs including the
mental health cluster system.
Provide each individual and family with a primary health care provider to assess
and monitor medical, mental health or substance abuse treatment and to
facilitate a long-term primary care relationship. Ensure that treatment is
provided when it is requested. Establish liaison workers at existing health
centers, emergency rooms and treatment centers to ensure continuity of support
services, monitoring of discharge patterns, and each individual's ability to access
the housing and support services for which they are eligible.
Action Needed -Expand on centralized assessment and referral system of Target
Cities Program of Community Substance Abuse Services, a program of the DPH,
to establish centralized intake and comprehensive health assessment and
monitoring of each individual’s substance abuse, mental health treatment and
medical care. Maintain confidentiality of all data based information.
Action Needed - Monitor proposed managed health care systems to ensure that
these systems do not add levels of assessment and referral which create barriers
to health care for homeless individuals. Ensure consistency with the integrated
continuum of health services to homeless individuals. Monitor success of
mental health cluster system in providing immediate accessible treatment to
homeless people.
Action Needed - Expand mobile crisis, mental health and medical intervention
outreach at SRO’s and supportive housing programs.
Action Needed - Require joint planning between DSS, DPH, and other city
departments to insure coordinated strategies and funding of services, especially
Continuum of Care Plan - Draft Page 50 October 18, 1994
for individuals diagnosed with substance abuse, mental health and medical
problems including AIDS/HIV+.
Action Needed - Create 20 inpatient medical detox beds for adults and youth
beyond the current 55 detox beds. Include on-site medical and mental health
services. Expand transportation services.
Action Needed - Create 100 additional intensive, short-term substance abuse
treatment beds and an additional 100 beds for integrated mental health,
substance abuse and primary care treatment to include special service programs
beyond the current 87 intensive short term substance abuse treatment beds
targeted for homeless people.
Action Needed - Create a 50-75 bed Safe Place Facility for homeless people who
are dually and tripally diagnosed (substance abuse, psychiatric disability, HIV+),
and need respite from the streets, but are not ready or able to enter treatment
programs.
Strategy 6
Centralize Intake and Information for Families Who are Homeless, or
Threatened with Losing Housing
Action Needed - Establish Family Support Centers (See Prevention Element) to
provide prevention and emergency services for families at risk of losing
housing. Establish centralized and computerized intake into all family shelters.
Link up with Housing Data Base.
Strategy 7
Gradually Reduce Shelter Capacity For Families as Supportive Housing is
Developed (See Housing Element)
Action Needed - As supportive housing and other housing resources become
available, and as demand declines, gradually reduce the number of emergency
shelter beds for families with the exception of battered women’s shelters.
Reallocate funds for emergency shelter to eviction prevention and follow-up for
families.
Strategy 8
Expand Emergency Shelter for Women who are Victims of Domestic Violence
Action Needed - Create an additional 80 shelter beds for single women and
women and their children who are victims of domestic violence. Reserve 30 of
the 80 beds for women who are victims of domestic violence and have substance
abuse problems. Over the next five years, increase General Fund allocations for
battered women’s safe houses.
Continuum of Care Plan - Draft Page 51 October 18, 1994
Strategy 9
Expand Emergency Services for Youth
Action Needed - Expand outreach beyond Civic Center, Polk Gulch, and Haight.
Monitor usage of existing shelter beds to determine capacity needs. Explore
alternatives to shelters such as hotel vouchers, foster homes, drop-in crash pads.
Provide emergency hotel vouchers for youth 18-21 years or designate existing
smaller adult shelters for older youth. Streamline benefit process for youth.
Action Needed - Increase access to new locked units (sub-acute beds) at SFGH
for very low income youth. Increase substance abuse treatment including 3-5
day detox, residential and outpatient.
Continuum of Care Plan - Draft Page 52 October 18, 1994
TRANSITIONAL HOUSING AND SERVICES
FIVE YEAR STRATEGIES
Transitional Housing and Services provide a transition for homeless individuals,
youth, and families who have substance abuse, mental health, or personal
problems which need to be addressed before they can move to permanent
housing. Transitional services are usually time-limited with a range between six
months and two years.
Included in this element are residential treatment programs for individuals with
mental health and substance abuse problems; group homes for runaway,
troubled or homeless youth; and transitional housing programs for homeless
families with children. Outpatient mental health and substance abuse treatment
is included in the transitional element although these services will be available
throughout the continuum and for lengths of time ranging from several days to
several years.
Strategy 1
Provide Inpatient and Outpatient Health Care For People with Mental Health
and/or Substance Abuse Problems, and/or Medical Problems.
Action Needed - Create 200 additional outpatient treatment slots including
methodone maintenance and outpatient detox. Create an additional 200
outpatient slots for people with mental health and substance abuse and/or
primary health problems. Create continuing care health teams to support
ongoing recovery and primary care needs.
Action Needed - Create an additional 400 beds for substance abuse recovery and
an additional 400 beds for people with substance abuse and /or mental health
and/or primary care problems especially for underserved populations such as
youth, women, and families.
Action Needed - Integrate the Step Project, a substance abuse treatment strategy
which is a joint effort of the Mayor’s Office of Housing and DPH, with the health
and social services component of the Continuum of Care.
Strategy 2
(Families) Increase Transitional Housing and Services for Families with
Substance Abuse Problems and Encourage Family Preservation.
Action Needed - Create a transitional housing program with support services for
head or heads of households with substance abuse problems. Few existing
residential programs include the entire family and families must often give up
their children in order to seek treatment. Existing transitional housing programs
require sobriety for families. Coordinate planning with Mayor’s Office of
Continuum of Care Plan - Draft Page 53 October 18, 1994
Housing, DSS and Community Substance Abuse Services.
Strategy 3 :
Increase Transitional Housing Services for Battered Women with Children.
Action Needed - Establish a transitional housing program for women and their
children who are fleeing domestic violence. Existing time limits in domestic
violence shelters do not permit families the time to resolve financial, housing or
safety issues. Existing programs do not provide the confidentiality to ensure the
family or woman’s safety. Coordinate planning with Commission on Status of
Women, Mayor’s Office of Housing and local non-profits. Provide training for
staff of all shelters, transitional programs and residential treatment programs on
issues of domestic violence.
Strategy 4
(Youth) Provide Transitional Housing, Treatment and Support Services
Following Emergency Services.
Action Needed - Replicate DSS alternative foster and group home models of
care. Expand existing agency-sponsored transitional living programs for youth
such as Orlando House and Guerrero House. Develop SRO’s and studios for
transitional housing and services for youth over 18 years. Require savings plan
for all youth in sponsored housing programs. Expand job training and
employment options for youth prepared to work.
Continuum of Care Plan - Draft Page 54 October 18, 1994
PERMANENT HOUSING
FIVE YEAR STRATEGY
Throughout the planning process, permanent housing emerged as a pivotal
component of the Continuum of Care. Housing — meaning a decent, affordable,
and safe place to live — must be at the core of our plan to address the problem of
homelessness.
Over the last several years there has been a growing understanding that
housing alone, without other services and supports, is not the "solution" to our
persistent inability to house our poorest residents. This understanding has given
rise to the concept of supportive housing, also known as service-enriched
housing. Supportive housing is defined as housing affordable to persons
with no or very little income that includes access to a range of services
designed to assist persons in maintaining their housing and achieving a
greater level of personal stability. Common sense tells us that the goal of
housing homeless persons and improving their long term social, health, and
economic conditions can only be achieved through the coordinated access to
both housing and services. The current environment in which, for example, a
person may come off the streets into a residential drug treatment program only
to return to the streets following treatment due to a lack of access to housing,
will never achieve substantial success.
For purposes of the housing component of the Plan, the discussions of housing
production refers to permanent supportive housing. While there is a percentage
of homeless persons who may not need support services and simply require
affordable housing, the real challenge to the system is to develop a stock of
housing that is linked to a flexible range of services that can meet the often
multiple needs of homeless persons.
HOUSING STRATEGIES
The following section summarizes key strategies that should be incorporated
into a supportive housing production plan.
Strategy 1 :
Target Extremely Low-Income People
Supportive Housing developed under this Plan must be geared toward
individuals and families that are of extremely low-income or earn less than 20%
of median income. Homeless individuals and families should pay a maximum
of 30 percent of their income for rent. Supportive Housing produced under this
Continuum of Care Plan - Draft Page 55 October 18, 1994
Plan needs to be explicitly available to individuals receiving General Assistance
or SSI and to families receiving AFDC.
Action Needed - Development of financing mechanisms that include long-term
operating support for projects. This includes project based existing Section 8
certificates and vouchers to the maximum extent possible, supporting efforts by
the Housing Authority to aggressively pursue new Section 8 subsidies as they
become available, and developing alternative funding sources to cover on-going
operating funds. Such alternatives could include the use of Tax Credit equity
for operating reserves and the establishment of a rental subsidy program based
on local funds.
Strategy 2
Develop Housing for Mixed Populations
Repeatedly, throughout the continuum of care planning process, participants
expressed the desire to promote the development of mixed population buildings
as a way to encourage normalization and the development of a healthy
residential community.
Action Needed- Development of policies that encourage supportive housing
sponsors to house persons of varying income, levels of disability, and
household size. In addition, supportive housing planning should include non-
traditional living configurations to accomodate the needs of special populations.
Critical to this effort is the streamlining of support service funding to allow
sponsors to access interdisciplinary services funding from a single source.
Traditionally, given restrictions imposed by funding sources, this has been
difficult to do. As part of the implementation of this Plan, such barriers should
be overcome.
Strategy 3
Integration of Services
Supportive housing can not work unless there is an established mechanism for
the integration of support services and affordable housing. Both components are
equally as important to the successful long-term operation of a development. In
San Francisco, the coordination of funding for support services and capital
development needs further refinement.
Action Needed - Housing money is allocated in funding pools on an annual
basis. These funds are relatively flexible and available for a range of projects.
Residentially based support services funding needs to be aggregated in a pool
similar to the housing funds. Currently funds for support services generally
come from the Department of Social Services (DSS) and/or the Department of
Public Health (DPH) and are allocated on a line-item basis through the City's
regular budget process. These funds have been difficult to access in a timely
Continuum of Care Plan - Draft Page 56 October 18, 1994
fashion when development opportunities arise and consequently, opportunities
are lost and supportive housing sponsors are deterred from pursuing such
developments because of inaccessible service funds.
Action Needed — Develop a collaborative funding process that provides project
sponsors with the local share of capital, operating , and services funds required
to successfully develop and operate supportive housing projects.
Action Needed —- Development of additional sources of funding for the
provision of residentially based support services. This could include attracting
funding for services from "managed care" funding systems and redirecting funds
from high cost institutional setting (ie. hospitals, jails) to more appropriate and
less costly supportive housing environments.
Strategy 4
Flexible Access to Services
While there is detailed discussion of needed services for various homeless
populations elsewhere in this document, there are a few points worth
mentioning regarding services as they relate to a residential setting. Most
supportive housing developments combine a mix of on and off-site services.
Services most often provided on-site include less intensive and less costly
services such as case management, information and referral, assistance with
daily living activities, and community building. More intensive and specialized
services such as medical care and substance abuse treatment are secured off-site.
Action Needed — Policies need to be developed that encourage sponsors to
provide a flexible range of services that are available on a volunteer basis to
residents. Experience has demonstrated that most homeless individuals and
families will avail themselves of needed services if they are provided ina
culturally competent and non-threatening manner. Service staff should be able
to accommodate the needs either directly or through referral, of formerly
homeless persons, including those persons with multiple disabilities.
Action Needed- Supportive housing developments should be distinguished
from from one another based on the level of services available rather than by any
specific disability. As we develop our stock of supportive housing it may be
helpful to categorize projects under the following two broad categories: 1)
Moderate Service Level/ Mixed Population, and 2) Intensive Service
Level/Single Population.
Strategy 5
Development of Supportive Housing Throughout the City
Much of the affordable housing that has been developed over the last 15 years
has been concentrated in the central city neighborhoods of the Tenderloin, South
Continuum of Care Plan - Draft Page 57 October 18, 1994
of Market, and the Mission district. Many homeless individuals and families
coming out of shelters, transitional housing, or other temporary locations, do not
want to return to neighborhoods with high rates of crime and drug use.
Additionally, individuals and families should have the option of returning to
neighborhoods in which they have family or other support systems.
Action Needed - Recognition on the part of local government that development
costs will be more expensive in some neighborhoods and therefore may require
higher than customary per unit development costs.
Action Needed — Education around the need for supportive housing and its
positive impacts on a neighborhood. It is imperative that this work be done on
a neighborhood-by-neighborhood basis prior to specific developments being
proposed for specific neighborhoods.
Action Needed — In cases where development of housing is not practical, or not
immediately available (ie. larger units for families) support increased rental
assistance options in the private market. Expand existing models, such as
Project Homeward Bound, that develop relationships with property owners and
facilitate housing placements.
THE PRODUCTION PLAN
The central purpose of the housing component of the Continuum of Care is to
formulate a five year strategy for the production of supportive housing.
Defining the precise need for supportive housing is very difficult and,
depending on how you define the homeless population, the number of units can
become exceedingly large. Because housing production is not an exact science
and is often governed by development opportunities and available resources, the
numbers and assumptions in this section serve to guide the overall thrust of the
housing plan, and indicate a range of financial resources that will be required to
achieve any given level of production.
Housing Need
In trying to establish the overall potential need for supportive housing, we
looked at the following two major populations: 1) extremely low-income
persons who are at risk of becoming homeless because they are over—crowded,
over—paying for housing (more than 50% of income), and/or living in
substandard units; and 2) those persons broadly defined as homeless which
includes people living on the streets, in shelters, and people in residential
treatment, transitional housing, and jails who do not have a permanent place to
live.
Continuum of Care Plan - Draft Page 58 October 18, 1994
Determining the exact number of persons at risk of loosing their housing is
difficult at best. The following are some statistics that address the magnitude of
this population: 24,212 extremely low-income households pay over 50% of their
income for rent; 25,600 extremely low-income households are living in
overcrowded conditions (CHAS 1994). The issue of persons at risk of becoming
homeless is important and needs to be addressed as part of San Francisco's
continuum of care. However, because it is not strictly a housing development
issue and given the fact that this population is in relatively less dire
circumstances than the homeless persons, the housing production plan centers
around trying to assist people on the streets and in other short term emergency
situations.
As referred to in the introduction of this document, there are no definitive
counts of the San Francisco homeless population. Various counts measure parts
of the homeless population including persons homeless on one night, persons
who experience an episode of homelessness in one year, numbers of people
turned away from shelter, etc. For purposes of the housing production plan,
the homeless population is estimated to be 7,000 persons. While the accuracy
_ of this number can not be proved, it serves as a middle ground among some of
the estimates and as a starting point to begin quantifying the cost of housing this
population. The following description of methodology and resulting estimates
is based on a 7,000 person estimate. It should be noted that there are estimates
that place the homeless count in the range of 10,000 — 15,000 and therefore, the
resulting cost to house this population would be considerably higher. As
discussed below in more detail, given the reality of the funding environment, it
is highly unlikely that the City could produce 7,000 units of supportive housing
over five years, let alone numbers corresponding to the higher range.
Production Plan Projections
In order to arrive at an estimate of the cost of producing units the following
methodology was used. (See tables at the end of this section for more detailed
figures).
The following four different unit type categories were established that
correspond with different development costs: 1) SRO/Studio Units, 2) One &
two Bedroom Units, 3) Three & four Bedroom Units, and 4) Specialized Units,
most often small scale congregate facilities that are licensable.
The 7,000 homeless estimate was divided into sub populations that correspond
to unit sizes. The main cut of the homeless population was done along
household size using the estimate that 75% of the population is single persons
and the remaining 25% is families. The general assumption was made that most
singles will utilize an SRO or studio apartment and most families will live in
either one and two bedroom apartments or three and four bedroom apartments.
Continuum of Care Plan - Draft Page 59 October 18, 1994
For families, based on information from family homeless shelters and AFDC
data, it is assumed that 60% of homeless families consist of one parent and two
children and 40% consist of households of four persons or more, and that the
average homeless family size is 3.5. In addition, the housing preferences that
are known about homeless persons with mental disabilities was also factored in
to account for the fact that not all single persons prefer or are able to live alone.
Based on this analysis, the supportive housing production plan would need to
produce 4,447 SROs and studios, 678 one and two bedroom apartments, 578
three and four bedroom apartments, and 47 specialized facilities to house the
estimated 7,000 homeless persons.
Cost models were developed for the four different types of housing units
identified above. This was done by analyzing costs of affordable housing
projects developed over the last two years. Drawing upon cost figures from 31
projects, low, high, and average costs per unit were calculated for both total
development cost and local contribution to the project. State funds that are no
longer available and McKinney funds that will likely be coming in the form a
block grants were included in the calculation of local contribution. The local
contribution is an important figure because it defines what our local funding
level must be to achieve a desired level of production.
Finally, based on the above described cost figures and unit type breakdown, the
following estimate was calculated. To develop supportive housing for 7,000
homeless persons over five years, the local cost would be approximately
$241,921,388 and the total development cost would be $536,833,319. As a point
of comparison if one chooses a homeless estimate from the higher range, for
example 13,000 persons, the local cost would be approximately $445,903,112.
Based on past expenditure for supportive housing and a projection of housing
funds likely to be available for future development, the City anticipates
approximately $15 million available annually, or approximately $75 million
available over the next five years, for the development of supportive housing.
Based on above cost estimates, the City has approximately 31 % of the funds
needed to house the estimated 7,000 homeless.
There will not be sufficient local resources available to achieve this level of
production and therefore the Continuum of Care Plan must prioritize the use of
local resources. It is important to recall that some prioritization has already
occurred with the emphasis on developing permanent supportive housing for
homeless persons rather than the substantially larger population of households
identified as at risk of homelessness. Realistically, the production plan will not
be able to achieve the 7,000 unit level of production over 5 years but the City
must attempt to reach beyond the levels dictated by currently available
Continuum of Care Plan - Draft Page 60 October 18, 1994
resources. In order to reach critical mass and make a noticeable impact on the
homelessness problem, the Plan proposes a goal of doubling available
resources over the five year period to $150 million or $30 million per year.
This funding level would yield approximately 3,749 units of supportive
housing over five years. Another way to interpret these figures is that for
every $40 million committed to supportive housing development,
approximately $1,000 units can be developed. The estimated number of units
per unit type and the local cost is summarized below assuming a $150 million
five year goal:
Table 1
TOTAL 3,749 $150,000,000
While the figure of 3,749 units and $150 million is somewhat arbitrary, the
central point of a production plan is to provide a goal and a structure for the
City's effort to produce supportive housing units. Based on the above estimates,
we have a guide as to what type of units are needed an what the local cost is to
produce those units.
Table 2
Breakdown of Homeless Population by Housing Type
SRO/STUDIO 1-2 3-4 BDR_ | SPECIALIZED TOTAL
BDR. FACILITY
SINGLE 4,447 378 378 47 5,290
Er Cet baer ap bn ell] ane
SMALL 300 300
HOUSEHOLDS
LARGE
HOUSEHOLDS
TOTAL G years) ia? 5750
TOTAL (years) | = |S | Cte | SSCSC~«SYCC~«* ABO
PERCENTAGE 77% 12% 10% 1% 100%
Continuum of Care Plan - Draft Page 61 October 18, 1994
Table 3
Cost Models for Unit Types
SRO/STUDIO 1-2 BDR. 3-4BDR | SPECIALIZED
ala aoe hv ad
AVERAGE 37,330 41,274 77 ,A25 67,648
COST
HIGH 58,698 58,698 112,570 106,219
COST
LOW 20,697 17,9135 1) 40,191 36,436
COST
Table 4
Local and Total Development Cost to Produce 7,000 Supportive Housing Units
TOTAL DEVELOPMENT LOCAL DEVELOPMENT
COST COST
SRO/STUDIO $338 576,792 $166,006,510
SMALL APARTMENT $73,969,800 $27,983,772
LARGE APARTMENT $120,468 ,494 3 $44,751,651
SPECIALIZED FACILITIES $3,818,233 $3,179,456
TOTAL (5 years) $536,833,319 $241,921,388
TOTAL (1 year) $107,366 664 $48,384,278 |
Continuum of Care Plan - Draft Page 62 October 18, 1994
FOLLOW-UP AND SUPPORT SERVICES
- FIVE YEAR STRATEGY
Follow-up occurs throughout the continuum to ensure that each person has
access to the treatment and support services necessary to maintain housing,
health and income, and to monitor the success of the individual and the system
in meeting these goals. Support services include legal services, counseling,
money management and entitlement assistance, childcare, food, and
transportation services.
Follow-up provides the critical links along the continuum for people leaving
emergency shelters, transitional housing and institutional settings, as well as for
newly housed homeless people and those at risk of homelessness. Follow-up
strategies include peer support groups, outreach to schools and community
agencies, and linkages between health care providers to ensure coordinated
health and social service support.
Strategy 1
Ensure Continuity of Health Care and Social Services
Action Needed -Expand on the centralized assessment and referral system of
Target Cities Program of Community Substance Abuse Services to ensure
monitoring and follow-up of treatment and support services.
Action Needed - Primary health care providers will monitor progress of
substance abuse, mental health and medical care. Utilize liaison workers to
monitor discharge patterns, ensure that homeless individuals are linked into the
system and that individuals and families are accessing all housing, treatment
and social services for which they are eligible.
Strategy 2
Identify Family Support Centers in Each Neighborhood To Link Formerly
Homeless Families with Services.
Action Needed - Collaborate with the City’s Family Preservation Planning
Group to designate family support centers in each neighborhood to provide
support to newly housed formerly homeless families including linkage to
childcare, health and counseling services. Develop agreements with support
centers and family shelters. Monitor existing family follow-up projects at
Raphael House and Travelers Aid. Funds needed for neighborhood-based peer
support staff.
Strategy 3
Improve Access to Free or Low-Cost Legal Services
Action Needed - Expand availability of pro bono and low cost legal services by
Continuum of Care Plan - Draft Page 63 October 18, 1994
supporting non-profit legal services and utilizing and leveraging volunteer
attorneys to provide services to low-income persons.
Strategy 4
Expand Use of Food Stamps to Provide Meals at Supportive Housing Sites
Action Needed - Using Baldwin House Community Food Program as an
example, expand the use of food stamps for the delivery of hot meals to
residents of supportive housing and SRO hotels. Baldwin meals are paid for
with food stamps of residents and prepared daily by the Multi-Service Centers.
Strategy 5 :
Expand Access to Food Services for Homeless and Formerly Homeless People
and People at Risk of Homelessness
Action Needed - Strengthen linkages among food providers, homeless services,
neighborhood centers, and health centers. Link food providers with designated
neighborhood-based programs and target food programs in high-risk
neighborhoods
Strategy 6
Expand Access to Clothing and Housewares for Homeless and Formerly
Homeless People
Action Needed - Link retailers, wholesalers, and homeless programs with the
San Francisco Clothing Bank. Coordinate access to donations for clothing
through InfoLine and purchase or get van donated for Clothing Bank to deliver
clothing.
Strategy 7
Establish a Community-Based Clothes Closet and Housewares Program.
Action Needed - Support efforts in neighborhoods outside of the Tenderloin to
establish clothing closets. Coordinate with and seek technical assistance from St.
Anthony Foundation and the bay Area Women’s Resource Center.
Strategy 8
Expand Existing Number of Subsidized Homeless Childcare Slots From the
existing 18 Slots to 54 Slots.
Action Needed - Develop 36 new childcare slots for children in family and
domestic violence shelters (4 at the Tenderloin Childcare Center and 36 at the
proposed Family Support Center ( See Prevention Component). Provide
childcare with counseling services for up to one year.
Strategy 9
Expand Subsidized Childcare Slots for Very Low Income Families.
Action Needed - Support local, state and federal efforts to expand childcare
particularly for parents in educational and job-training programs.
Continuum of Care Plan - Draft Page 64 October 18, 1994
Strategy 10
Expand Counseling and Mental Health Services for Homeless Children, Youth
and Their Families Who Are Moving Out of Shelters to Permanent Housing.
Action Needed - Utilize the Homeless Children’s Network as an example of
follow-up counseling and mental health services for children and their families
who relocate from shelters to permanent housing. Expand counseling staff to
provide direct services and improve links with community-based health
services.
Strategy 11
Expand Transportation Services for Children and Youth Living in Shelters
Action Needed - Reevaluate SFUSD feeder school proposal to provide for more
flexibility. Increase bus coupons available through MUNI for children and youth
in shelters.
Strategy 12
Expand Transportation Services for Homeless People To Access Treatment
Services and Support Programs.
Action Needed - Expand Mobile Assistance Patrol Transportation Program.
Access bus tokens and MUNI passes for people in shelters and residential
treatment programs.
Continuum of Care Plan - Draft Page 65 October 18, 1994
EMPLOYMENT AND TRAINING PLAN
Introduction
Employment is a critical source of income, security and satisfaction. Yet, social
and economic conditions, as well as personal challenges, do not make it possible
for all people to secure or maintain regular, gainful employment. People without
marketable skills, education and opportunity struggle against the odds to
become economically self-sufficient.
As discussed in a previous chapter of this plan, economic shifts over the past 20
years have caused a significant decline in well-paying manufacturing and
unskilled labor jobs. At the same time, low-paying service sector positions, as
well as part-time and temporary jobs without health benefits are increasing. In
San Francisco, the service industry is expected to gain the majority of new jobs
(both full and part-time) between 1990 and 1997. Business services, including
engineering, accounting and research services; health services; and legal services
are the largest categories within this industry (Annual Planning Information,
_ 1993, State of California Employment Development Department). The top four
occupations with the greatest absolute job growth (total number of new jobs)
will be guards, janitors, retail sales clerks, and lawyers (Projections of
Employment, 1993, EDD).
If homeless people are to move up the economic ladder and out of poverty, they
must have the skills and opportunities to earn a living wage. For those who
cannot work, adequate income maintenance supports must be available to pay
for their basic needs.
The education and work experience of homeless families and individuals
residing in San Francisco’s shelters in 1993-94 illustrate the diversity of the
homeless population as well.as the prevalent need for education and retraining.
As described earlier in this plan, almost one-half (41%) of the single parents had
not completed high school and/or had no work experience. On the other hand,
21% of the single parents had some college and had received a BA degree. Of the
parents who had worked, nearly half (46%) had held clerical/office support
positions. In general, more of the single adult population had finished high
school, men (64%) and women (59%), than did the single parents. Almost three
quarters (72%) of the single adult population had had some work experience,
from part -time to full time for five years or more. Of the men, 50% had worked
in unskilled jobs. Of the women one fourth (23% ) had no work skills and 25%
had worked in clerical jobs. (DSS, 1994)
For both homeless parents and single adults, limited work experience and job
skills for only low paying and shrinking sectors of the economy present
Continuum of Care Plan - Draft Page 66 October 18, 1994
significant barriers to gainful employment. These barriers are exacerbated by
other challenges such as a lack of appropriate clothing, stable housing, a regular
phone number, or adequate child care. Additionally, homelessness can
constitute a major assault on a person's self-confidence and ability to succeed.
Emotional stress and/or substance abuse problems are further ehalenges for
some people to overcome.
Strategy 1
Develop an integrated “Continuum of Homeless Employment and Training
Services” (CHETS) which is coordinated with the housing and supportive
services elements of the Continuum of Care. Current efforts to assist homeless
people to address these barriers to employment are inadequate to meet the need.
While a handful of programs providing pre-employment services, job search
assistance, training and supportive employment opportunities for homeless
people do exist, they have only limited capacity, and are not sufficiently linked
into the array of community based and publicly funded employment and
training programs in San Francisco.
A “Continuum of Employment and Training Services” (CHETS) should be
developed to assist homeless people in obtaining marketable job skills and
suitable, permanent employment so that they can earn an income that enables
them to be self-supporting to the best of their ability. This CHETS network must
bring together the resources of community-based and publicly funded
employment and training agencies and an array of homeless housing and
services programs.
An "Employment Plan" should be developed for each person participating in
CHETS. The Employment Plan will help to ensure continuity of services as
people move through different components of this system, and the different
agencies that will provide them. It will also provide a tool for participants to
establish short and long-term vocational goals. This Employment Plan should
be initiated at a person's first contact with any agency within the CHETS
network of providers. |
The seven essential components of the proposed Continuum of Homeless
Employment and Training Services are summarized below. While every
homeless person seeking employment may not need to use each of these
components, all of them must be available and accessible to any CHETS
participant. It is proposed that residents of permanent supportive housing,
transitional housing and some longer-term shelters be the priority target
population for this system. Every component of the system should be designed
to appropriately meet the diverse needs of the homeless population, regardless
of language, culture or disability.
Continuum of Care Plan - Draft Page 67 October 18, 1994
Components of the CHETS System
1.
ay,
Basic Needs Stabilization
It is essential that a homeless individual or family’s basic needs are met
before, during and after they utilize employment and training services.
Without this fundamental level of stability, employment and training
service resources will be wasted and the person’s efforts undermined. Basic
Needs Stabilization includes having reliable housing/shelter and food,
transportation, tools, books, access to a phone and/or voice mail,
appropriate clothing, and facilities for grooming. Physical and mental
health needs must be being met. For those addressing issues of substance
abuse, access to treatment or other support is seg ok Parents must have
adequate child care for their children.
Homeless programs must retain primary responsibility for ensuring that
the basic needs of CHETS participants while they are involved in any
component of the system. The staff of participating homeless programs will
be the first point of assessment and referral into the various components of
the CHETS system.
. Vocational Assessment & Skills Testing
The purpose of the Vocational Assessment & Skills Testing is to evaluate
the educational attainment, interests and aptitudes of people seeking
employment. For those who have been unemployed for an extended
period, or whose past work experience does not match the kinds of
employment opportunities available, this assessment and testing is a
particularly important step in career planning, and job placement.
. Basic Employability Skills & Education
The goal of Basic Employability Skills and Education is to ensure that
participants have the essential skills and work habits needed to obtain and
maintain a job. These skills include the ability to communicate in English,
literacy, a high school degree or GED, and basic work habits such as
punctuality and interpersonal communication.
. Vocational Education & Occupational Training
The purpose of Vocational Education and Occupational Training is to
develop the knowledge, technical skills and/or practical experience a
person needs to obtain employment in their chosen field. Education and
training must be linked to real employment opportunities.
Job Readiness
Job Readiness services teach such skills as how to conduct a job search
(interviewing, resume writing, etc.), work place expectations, and labor
Continuum of Care Plan - Draft Page 68 October 18, 1994
market trends. Job Readiness should be included among the services
provided by Vocational Education, Occupational Training and nie Search
and Placement programs.
6. Job Search & Placement
The ultimate goal of the CHETS system is to help homeless people obtain
and maintain suitable, gainful and permanent employment. To be
considered "permanent" this employment should last for a minimum one
year period. For some people, transitional employment may be an
intermediary step leading to this long-term, permanent job. All people
should have the opportunity for a career path of upward mobility. Job
Search & Placement services include job development on behalf of client
(i.e. cold calling, advertising, networking, and working with employers to
create jobs, etc.), as well as providing resources and job listings to facilitate
a person's own job search.
7. Follow-up Support
Follow-up support is critical to ensuring a homeless person's success in
training and job retention. The goal of follow-up services is to provide the
stability, access to resources, and personal support that a person may need
to successfully navigate the challenges of employment, education or
training.
Action Needed
Develop standard criteria for determining if a person or family's basic needs
have been stabilized. Provide training to the staff of all programs/agencies
which are part of CHETS to ensure that the expectations of Basic Needs
Stabilization are understood; to orient staff to the different components of the
system and what each offers; and to promote inter-agency cooperation and
responsibility.
Action Needed
Identify or develop the services and resources to implement each component of
the CHETS system described above. Work with “mainstream” agencies (e.g.
City College, Department of Rehabilitation, Private Industry Council,
universities and technical schools, hiring halls and community based
organizations) to facilitate the use of their services by homeless people. These
agencies should be utilized as the primary providers for each component of the
CHETS system, with the exception of Basic Needs Stabilization. Provide
funding and technical assistance to increase agency capacity and ability to work
with CHETS participants.
Specifically, identify and fund a minimum of two agencies to provide Vocational
Assessment and Skills Testing to CHETS participants. Assemble and use
Continuum of Care Plan - Draft Page 69 October 18, 1994
assessment and testing tools, instruments and methods which are appropriate
for the diverse and unique circumstance of the homeless population. Identify
and fund 3-5 community based job placement agencies to provide job search and
job placement services for CHETS participants.
Action Needed
Identify and obtain the resources homeless individuals and families require to
fully participate in employment and training services. These include: designate
child care slots, fast passes and/or bus tokens, money to buy tools and books,
access to a phone and/or voice mail, and appropriate clothing.
Action Needed
Develop a CHETS services referral directory to be used by homeless job seekers
and agency staff. This information should be available both on computer and in
writing.
Action Needed
Expand the capacity of programs such as the Episcopal Community Services
Adult Education for the Homeless Program to provide Basic Education and
Employability skills. Establish limited basic education and ESL courses on-site
in homeless programs where the need for such classes exists. The goal of these
in-house classes should be to engage residents in the learning ie ae and help
them to make the transition into community based programs.
Action Needed
Establish a "liaison" at the Department of Rehabilitation to facilitate referral of
homeless persons into the Department of Rehabilitation system.
Action Needed
Develop/assemble a Job Readiness curriculum that can be used as a whole or in
part by homeless programs and employment/training programs which are part
of CHETS:
Action Needed
Promote the use of peer training models which include mentorship and
information provided by formerly homeless and unemployed people.
Action Needed
Ensure that follow-up support is provided at every component in the CHETS
system and for up to one year after placement on a job. A commitment to
providing follow-up support services must be a prerequisite to any agency's
participation in CHETS. Measure the success and outcomes of CHETS
programs/components based on completion of education or training programs
and long-term maintenance of employment.
Continuum of Care Plan - Draft Page 70 October 18, 1994
Action Needed
Substantially increase the number of homeless people receiving training through
Private Industry Council (PIC) subcontractors receiving Job Training and
Partnership Act (TPA) funding. Support a regional initiative to change JTPA
reporting requirements, outcome expectations and other regulations which
discourage use of these funds to provide training for homeless people. Create
incentives for PIC contractors to recruit and enroll homeless people in the
CHETS system. Provide training to PIC contractors on how to make their
‘program more user friendly and effective for homeless people.
Action Needed
Promote the creation of on-the-job training and transitional employment
opportunities in homeless programs. Specifically, set aside a pool of program
operating funds to subsidize transitional employment positions within homeless
programs (i.e. child care, intake, maintenance, property management, etc).
These positions would provide paid on-the job training for a time limited period,
while fulfilling a service need at these agencies.
- Action Needed
Work with businesses to develop on-the-job training opportunities leading to
permanent employment.
Strategy 2
Strengthen income maintenance programs such as General Assistance (GA), Aid
To Families with Dependent Children (AFDC), and Social Security
Insurance(SSI). Ensure adequate income to meet basic needs, and eliminate
barriers to employment and training.
For people who are unemployed or unable to work, income maintenance
supports are available to pay for the basic expenses of living: food, clothing, and
shelter. However, as described earlier in this plan, the buying power and actual
dollar amount of these grants has declined steadily over the past several years.
For those people who can work, income maintenance programs should place a
greater emphasis on preparing recipients for work and helping them to find jobs.
In San Francisco, there are two programs located in the Employment and
Training Division of the Department of Social Services which seek to help
recipients of AFDC and GA to move off of welfare through training, support
services and job placement. The GAIN program serves parents with children
receiving AFDC. Some of the services available are child care, transportation,
training, vocational counseling, vocational assessment, job placement and
internships. Upon completion of the program and success in obtaining a job,
additional services are available including one year of child care and 3 years of
family medical coverage through MediCal and Kaiser.
Continuum of Care Plan - Draft Page 71 October 18, 1994
The GATES program serves employable persons receiving General Assistance
anc “ood Stamps to prepare for employment through a combination of training,
job seeking skills, case management, vocational counseling and supportive
services (transportation or ancillary expenses for tools, work clothes or books),
and direct job placement.
For both the GAIN and GATES programs, basic needs must be met before the
programs can be utilized effectively. There are currently 1,200 participants in
the GAIN program. It is unknown how many are homeless. The GATES
program serves 500 individuals at a time, of which 25-40 reside in transitional
housing or Single Room Occupancy hotels.
Action Needed .
Maintain GA, AFDC and SSI grants at an adequate level to meet recipient’s basic
needs.
Action Needed
Implement a wage subsidy program which provides partial reimbursement for
employers who hire GA recipients into permanent positions paying a livable
wage. Such a program will encourage employers to hire GA recipients and and
enable recipients who are hired to immediately leave GA.
Action Needed
Increase the limit on the amount of assets a person may have to apply for GA.
The asset limit
should be increased from $25 to $345.
Action Needed
Explore ways to simplify and expand the Income Disregard program through
which recipients of public assistance are able to retain part of their grant while
they work.
Action Needed
Evaluate the GAIN and GATES programs to identify ways to strengthen these
programs and integrate the resources of the proposed CHETS system with those
available through GAIN and GATES.
Strategy 3
Promote economic development strategies which create jobs for low-income and
homeless people.
The most comprehensive array of pre-employment services will have no value if
there are no job opportunities available. The largest solution to this challenge is
Continuum of Care Plan - Draft Page 72 October 18, 1994
one of broad economic growth. In addition, jobs can be created specifically for
homeless people by accessing existing publicly funded jobs through set asides
and hiring preferences. Supporting private, non-profit operated enterprises,
which, while initially subsidized, operate with the goal of generating sufficient
revenues to become self-supporting is another viable,though smaller scale,
approach as well.
Nonprofit enterprises provide either transitional, supported employment or
permanent employment for participants and graduates of homeless program.
The potential of these enterprises to employ large numbers of individuals is
limited due the capacity of the organizations pursuing this approach and the
limitations on even the most aggressive job growth strategy. In addition, most of
these efforts are "start-up" enterprises, entailing all the risk of such businesses.
Actions Needed
Promote the development of a regional public works initiative aimed at
residential construction, infrastructure, construction or the delivery of public
services.
Action Needed
Ensure that economic development strategies in the San Francisco Bay Area
create jobs for homeless people. Ensure that enterprise communities,
empowerment zones, and the conversion of Treasure Island provide a balance of
high and low skills jobs. Utilize job set asides, tax incentives and first source
hiring requirements.
Action Needed
Because of the complexity and risk involved in operating a business enterprise,
such efforts are best supported with discrete, focused technical assistance and
funding support appropriate to the organization's capacity. Undertake a
collaborative marketing strategy to promote the purchase of goods and services
from social venture enterprises employing homeless and formerly homeless
people.
Action Needed
Promote greater business sector and corporate involvement in providing
employment and training for homeless people. Encourage hiring and encourage
on the job training.
Continuum of Care Plan - Draft Page 73 October 18, 1994
CIVIL RIGHTS PLAN
This section describes a plan for ensuring that the civil rights of homeless people
are respected.
Homelessness for many people means that their private lives must be led in
public places. As a result, homeless people are often victims of discrimination
based on their status due to their impoverished appearance, lack of address and
other factors. Homeless people who are already protected by civil rights laws,
such as racial, religious, and other minorities, are especially vulnerable to
discrimination. Policies and procedures which denigrate the rights of homeless
people block access to the continuum of care and exits from homelessness.
Mainstreaming and Access
Mainstream programs must accommodate homeless people in order to avoid
duplication of effort and to prevent stigmatizing homeless people (Priority:
Home! the Federal Plan to Break the Cycle of Homelessness). All mainstream and |
homeless programs must be accessible to all homeless people.
Nondiscrimination
The following nondiscrimination principle shall apply to promulgation of rules
and policies, access to programs, all aspects of service and employment, and
implementation of laws and regulations (see Fair Housing Amendments Act,
Americans with Disabilities Act, Civil Rights Act of 1964, Rehabilitation Act of
1973, AB 2244).
"No entity, whether City official or department, housing or service provider,
business person, funder, advocate, homeless program participant, or resident of
the City, shall discriminate against anyone based on their race, color, religion,
creed, national origin, gender, disability, sexual orientation, immigration or
familial status, or age.”
A system for monitoring compliance with this principle shall be established and
the principle shall be communicated in a manner that is accessible to the whole
community.
Due Process
A process should be created or expanded to give recipients of housing and
services an opportunity to be heard before they are deprived of any benefits. The
successful shelter grievance procedure should be looked to as a model process.
Dignity in Policies and Program Rules
A. Reasonable rules: Any rule which violates the dignity of homeless
Continuum of Care Plan - Draft Page 74 October 18, 1994
participants or creates obstacles to successful participation in a program
must be justified by a compelling reason, such as safety. This is especially
true for people with severe mental disabilities. Rules must be
communicated in a manner that is accessible to the entire community.
B. Participation: Participation of homeless and formerly homeless people in
the planning, development and evaluation of programs and services is
necessary for the successful development and maintenance of a
continuum of care.
C. Confidentiality: Confidentiality of consumer and research subject
information must be strictly maintained. Information about consumers
should not be divulged to anyone without consumer consent, except in
the rare circumstances provided for in confidentiality laws.
D. Privacy: Publicly funded programs should be prohibited from mandating
prayer or adherence to certain lifestyle or family choices in exchange for
services. Mandatory drug testing policies implicate state constitutional
protections of privacy and should also be prohibited.
E. Property: Personal property belonging to homeless people should not be
discarded by City departments or non-profit agencies. People should not
have to part with pets and/or possessions in order to access housing and
support services.
Tenancy Rights and Stable Housing
A. Legal Services The City should support an easily accessible, centrally
located, and comprehensive system that provides legal services to people
facing eviction, family separation, or obstacles to securing public
assistance.
B. SRO's: Programs seeking to house homeless people in SRO's should
ensure that tenancies are created and buildings are up to Code. SRO's
which illegally evict residents before the end of one month in order to
avoid creating tenancies should be excluded from the program (see Cal.
Civil Code §1940.1).
C. Accommodation: Any law, policy or program requiring participation of
homeless people must ensure that people with disabilities are
accommodated. In the context of a mandatory modified payment
program requiring public assistance recipients to devote a portion of their
checks to cover the cost of SRO housing, this may mean providing people
with disabilities alternative housing or exempting them altogether from
coverage of the law. (Americans with Disabilities Act).
Continuum of Care Plan - Draft Page 75 October 18, 1994
D. Discharge planning: Housing and support service opportunities should
be identified, and placements made, for people discharged from
institutional settings, such as hospitals, jails, and detoxification centers.
E. Transitional housing: Transitional housing programs must comply with
landlord-tenant law or the Transitional Housing Misconduct Act (Health
and Safety Code §50580 et seq.) when seeking to discharge residents.
Integration into the community
The Local Board should proactively address the Not In My Backyard (NIMBY)
Syndrome by reviewing existing land use laws, policies and zoning codes to
ensure that the City is in compliance with the several federal and state
discrimination laws (Priority: Home! the Federal Plan to Break the Cycle of
Homelessness, Fair Housing Act, Americans with Disabilities Act, Comprehensive
Housing Affordability Strategy, AB 2244, housing element law, Government
Code §65008).
Involuntary Commitment
Emphasis must be placed on providing mental health treatment to people
diagnosed in need of such services; social services alone are not an appropriate
solution to diagnosed illness. After care and housing opportunities should be
available to people discharged from hospitals (WIC §5622(5)). No referral shall
be considered complete until an agency accepts responsibility for a mental
health client (WIC §5008(d)). The state's broad guarantees of the rights of people
with mental illness must be respected (WIC §5325.1).
Families Preservation
No family should be separated due to inadequate housing or support services
opportunities, so long as the family can otherwise care for the children. Some
courts have found a right to housing for homeless families in this situation.
Equality in Program Rules and Services Available
Services available for homeless people should be allocated according to the
respective needs of different communities of homeless people (families, singles).
Additionally, all rules should be applied equally to the entire homeless
community.
Safety
Policies should be reconsidered in light of safety concerns. The City should not
require anyone to live in SRO's or any other housing where there have been
repeated incidents of physical and/or sexual violence, the units are not
habitable, or there is poor management. The Local Board should scrutinize the
City's choice of SRO's and other housing.
Continuum of Care Plan - Draft Page 76 October 18, 1994
Treatment as Focus
The continuum of care is designed to serve homeless people. The focus of City
and non-profit resources should be on providing treatment where needed, such
as for those suffering from substance abuse, not on punishing the manifestations
of illnesses for which treatment is not readily available.
Local Board Responsibilities
1. The Local Board, described in the following section, must have authority to
review and make recommendations to the Mayor and the Board of
Supervisors on all homeless policies and legislation in light of these 11 civil
rights principles. The Local Board, in conducting its review, should hold
hearings in order to maximize community input, especially the input of
homeless people.
2. The Local Board should have authority to review implementation of laws
to see if they are having an improper, disproportionate effect on homeless
people and/or members of certain communities of homeless people (racial,
ethnic, religious, linguistic minorities; people with Bea ee, women;
families; vets; elderly; etc.).
3. The Local Board must certify that a department or agency's policies and
programs are in compliance with the 11 civil rights principles before
funding is available.
4. The Local Board should have the authority to monitor and propose new
laws and strategies that reinforce and expand civil rights for homeless
people.
5. At least 25% of Local Board members should be people recognized by the
community as advocates for the civil rights of homeless people. They may
assume a leadership role and serve as a resource on issues of civil rights.
6. The Local Board and its staff should adequately represent the racial,
cultural, linguistic, and cultural demographics of the homeless community
that they serve.
7. The Local Board should have the authority to request that both the City
and homeless housing and service providers explain the effects that their
policy or program changes will have on the homeless people they serve.
Continuum of Care Plan - Draft Page 77 October 18, 1994
Continuum of Care Plan - Draft Page 78 October 18, 1994
THE MANAGEMENT OF THE
CONTINUUM OF CARE PLAN SAN FRANCISCO
The goal of the Management Plan of the Continuum of Care is to ensure that the
Continuum of Care Plan is the official homeless plan for the City and County of
San Francisco. It is critical to the success of the Continuum of Care that this Plan
governs and guides all homeless budget and policy in San Francisco.
Authority of the Continuum of Care Plan
The Plan will be the official guiding document for the City on all homeless
policy and programs. The annual Plan will be presented for endorsement to all
relevant City commissions and formally adopted as the San Francisco Homeless
Plan by the Mayor and the Board of Supervisors.
The Plan’s budget authority will be carried out in the following manner:
Direct Authority -The Plan’s budget will directly determine the use of Housing
and Urban Development (HUD) Homeless Block Grant Funds. Maintenance of
effort will be enforced to ensure that Homeless Block Grant Funds are not used
to replace existing City homeless program allocations.
Indirect Authority - The Plan’s annual budget will recommendfunding priorities
for City Departments and contract agencies for all other federal, state and City
funds targeted for homelessness that requires City approval. Entities seeking
such City approval must first be certified as in compliance with the goals of the
Plan before their request can be considered by the Mayor and the Board of
Supervisors.
The Plan is intended to help guide the homeless funding decisions of
foundations and other non-City funding sources in order to encourage accord
with the Plan’s policies and goals. The Plan is intended to be the primary
document which guides homeless funding strategies and policy development in
the City.
The Local Board
The City will establish, in accordance with federal statute and HUD regulations,
a Local Board to govern the Continuum of Care Plan. The Local Board will
exercise all authority necessary in overseeing the development and
implementation of the five year and annual Plan.
Specific responsibilities and authorities of the Local Board will be all those
necessary to fulfill HUD requirements as well as to:
Continuum of Care Plan - Draft Page 79 October 18, 1994
ae
Develop and monitor the five year strategic and annual Plan
2. Authorize all use of Homeless Block Grant Funds and recommend to City
Commissions and Departments, the Mayor and the Board of Supervisors,
use of all other homeless targeted funds as in compliance with the Plan.
2
Sign off, before formal City adoption, on the Plan and associated HUD
applications.
4. Certify, before formal approval, that all City funded programs are in
compliance with the Plan
oO
. Identify and oversee the entity (or entities ) which will manage,
administer, and evaluate the use of Homeless Block Grant Funds.
6. Coordinate Homeless Block Grant Fund applications from local agencies
and make recommendations for funding.
7. Notify the public as to the availability of funds and hold public hearings.
8. Adopt and update the annual one-year Continuum of Care Plan
9. Work with relevant City departments to prepare performance and
progress reports on projects and with entity on Plan evaluation.
10. Review and make recommendations to the Mayor and Board of
Supervisors on all homeless policy and legislation. For new policy and
legislation, review must occur before formal adoption.
11. Foster public accountability in all aspects of the management of the Plan.
Composition of the Local Board
Final recommendations for San Francisco’s Local Board must await federal
action. HUD regulations will likely specify that the members of the Local Board
be appointed by the jurisdiction’s CEO. For the City, it is recommended that this
authority be shared between the Mayor and the Board of Supervisors.
Federal requirements will likely specify that the Local Board’s membership be
made up of homeless individuals and families, advocates, and representatives
from non-profit agencies, business, labor, community groups, and government
agencies.
Staff of Local Board
The Local Board will oversee the policy, budget and staff of the office
Continuum of Care Plan - Draft Page 80 October 18, 1994
responsible for managing all programs and activities that fall under the
authority of the Local Board. Staff will, among other responsibilities, directly
develop and carry out all responsibilities associated with the Five Year and
annual action Plan. This Office and staff will be accountable to the Local Board.
It is recommended that the staff be located in the existing Mayor’s Office of
Community Development (MOCD). MOCD has considerable experience
managing the Community Development Block Grant program, one similar to
that proposed for the Homeless Block Grant. Additionally, MOCD has existing
operations capable of providing administrative, fiscal, monitoring and
evaluation back-up for the Mayor’s Homeless Office.
Coordination
The Continuum of Care Plan is intended to encourage centralization of homeless
planning and policy among City departments and contract agencies. It is
recommended that the Local Board establish a mechanism to foster
communication and coordination between these diverse entities. Such a
mechanism will also provide valuable policy advice for the Local Board. All
existing provider organizations, and advocacy coalitions, as well as city
departments, should be involved in the formation of this mechanism.
Continuum of Care Plan - Draft Page 81 October 18, 1994
Continuum of Care Plan - Draft Page 82 October 18, 1994
BIBLIOGRAPHY
Alioto, Angela, President/SF Board of Supervisors. 1994. One by One Plan.
Children’s Defense Fund. 1991. Homeless Families: Failed Policies and Youn
Victims. Washington, D.C.
Lemann, Nicholas. 1994. The Myth of Community Development. New York
Times, January 9. New York.
Mayor’s Office of Housing, San Francisco. 1993. Comprehensive Housing
Affordability Strategy. CA.
Northern California Community Services Council, Inc. 1994. Creating Healthy
and Safe Communities. Draft. San Francisco, CA.
Office of the Mayor. 1989. Beyond Shelter: A Homeless Plan for San Francisco. :
San Francisco, CA.
Office of the President, Interagency Working Group. 1993. Priority: Home! The
Federal Plan to Break the Cycle of Homelessness. Washington, D.C.
Polaris Research and Development. 1993. Survey of Emergency Shelters for
Homeless Persons in San Francisco . Report for Travelers Aid San Francisco and
the San Francisco Council on Homelessness. San Francisco, CA.
Stanford Center for the Study of Families, Children and Youth. 1992. Welfare
Reform and Children’s Well-Being. Stanford, CA.
Stanford Center for the Study of Families, Children and Youth. 1991. The
Stanford Studies of Homeless Families, Children and Youth. Stanford, CA.
State of California, Employment Development Dept., Labor Market Division,
Annual Planning Information. 1993. San Francisco, CA.
U.S. Department of Housing and Urban Development (HUD). 1993. The D.C.
Initiative: Working Together to Solve Homelessness. Washington ,D.C.
U. S. Department of Housing and Urban Development (HUD) Office of
Community Development. 1994. Building Communities Together. Washington ,
JORG:
Continuum of Care Plan - Draft Page 83 October 18, 1994
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